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Svynarenko R, Cozad MJ, Lindley LC. An Age Group Comparison of Concurrent Hospice Care: A Cost-Effectiveness Analysis. J Hosp Palliat Nurs 2024; 26:219-223. [PMID: 38748541 PMCID: PMC11233226 DOI: 10.1097/njh.0000000000001037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
This study aimed to examine the cost-effectiveness of concurrent hospice care compared with standard care among pediatric patients of different age groups. Using a national Medicaid database of 18 152 pediatric patients enrolled in hospice care between 2011 and 2013, this study calculated and analyzed incremental cost-effectiveness ratios (ICERs) for concurrent care versus standard hospice care for children of 4 age categories: <1 year, 1 to 5 years, 6 to 14 years, and 15 to 20 years. The results indicated that the total Medicaid cost of hospice care was $3229 per patient per month (PPPM; SD, $8709) for those younger than 1 year, $4793 PPPM (SD, $8178) for those aged 1 to 5 years, $5411 PPPM (SD, $7456) for those aged 6 to 14 years, and $5625 PPPM (SD, $11459) for those aged 15 to 20 years. Incremental cost-effectiveness ratio values across all age groups showed that children enrolled in concurrent care had fewer live discharges but at a higher Medicaid cost of care as compared with those enrolled in standard hospice care. Concurrent hospice care was the most cost-effective in the age groups of <1 year and 1 to 5 years, with ICERs equal to $45 (95% confidence interval [CI], $23-$66) and $49 (95% CI, $8-$76), respectively. For the other older age groups, benefits of enrollment in concurrent care came at a much higher cost: in the age group of 6 to 14 years, ICER was equal to $217 (95% CI, $129-$217), and in the age group of 15 to 20 years, it was $107 (95% CI, $82-$183). Concurrent hospice is an effective way to reduce live discharges but has a higher total Medicaid cost than standard hospice care.
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Affiliation(s)
- Radion Svynarenko
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
| | - Melanie J. Cozad
- Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Lisa C. Lindley
- College of Nursing, University of Tennessee, Knoxville, Tennessee, USA
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Nabukalu D, Gordon LG, Lowe J, Merollini KMD. Healthcare costs of cancer among children, adolescents, and young adults: A scoping review. Cancer Med 2024; 13:e6925. [PMID: 38214042 PMCID: PMC10905233 DOI: 10.1002/cam4.6925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/08/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE To collate and critically review international evidence on the direct health system costs of children and adolescents and young adults (AYA) with cancer. METHODS We conducted searches in PubMed, MEDLINE, CINAHL, and Scopus. Articles were limited to studies involving people aged 0-39 years at cancer diagnosis and published from 2012 to 2022. Two reviewers screened the articles and evaluated the studies using the Consolidated Health Economic Evaluation Reporting Standards checklist. The reviewers synthesized the findings using a narrative approach and presented the costs in 2022 US dollars for comparability. RESULTS Overall, the mean healthcare costs for all cancers in the 5 years post diagnosis ranged from US$36,670 among children in Korea to US$127,946 among AYA in the USA. During the first year, the mean costs among children 0-14 years ranged from US$34,953 in Chile to over US$130,000 in Canada. These were higher than the costs for AYA, estimated at US$61,855 in Canada. At the end of life, the mean costs were estimated at over US$300,000 among children and US$235,265 among adolescents in Canada. Leukemia was the most expensive cancer type, estimated at US$50,133 in Chile, to US$152,533 among children in Canada. Overall, more than a third of the total cost is related to hospitalizations. All the included studies were of good quality. CONCLUSIONS Healthcare costs associated with cancer are substantial among children, and AYA. More research is needed on the cost of cancer in low- and middle-income countries and harmonization of costs across countries.
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Affiliation(s)
- Doreen Nabukalu
- School of HealthUniversity of the Sunshine CoastSippy DownsQueenslandAustralia
- Population Health ProgramQIMR Berghofer Medical Research InstituteHerstonQueenslandAustralia
| | - Louisa G. Gordon
- Population Health ProgramQIMR Berghofer Medical Research InstituteHerstonQueenslandAustralia
- School of NursingQueensland University of TechnologyKelvin GroveQueenslandAustralia
- School of Public HealthThe University of QueenslandHerstonQueenslandAustralia
| | - John Lowe
- School of HealthUniversity of the Sunshine CoastSippy DownsQueenslandAustralia
| | - Katharina M. D. Merollini
- School of HealthUniversity of the Sunshine CoastSippy DownsQueenslandAustralia
- Sunshine Coast Health InstituteSunshine Coast University HospitalBirtinyaQueenslandAustralia
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Widjaja E, Demoe L, Yossofzai O, Guttmann A, Tomlinson G, Rutka J, Snead OC, Sander B. Health Care System Costs Associated With Surgery and Medical Therapy for Children With Drug-Resistant Epilepsy in Ontario. Neurology 2022; 98:e1204-e1215. [PMID: 35169008 DOI: 10.1212/wnl.0000000000200026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/03/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Improvement in seizure control after epilepsy surgery could lead to lower health care resource use and costs, but it is uncertain whether this could offset the high costs related to surgery. This study aimed to evaluate phase-specific and cumulative long-term health care costs of surgery compared to medical therapy in children with drug-resistant epilepsy from the health care payer perspective. METHODS Children who were evaluated for epilepsy surgery and treated with surgery or medical therapy from 2003 to 2018 at the Hospital for Sick Children in Toronto were identified from chart review and linked to their health administrative databases in Ontario, Canada. Inverse probability of treatment weighting with stabilized weights was used to balance the baseline covariates between the 2 groups. Patients were assigned to presurgery, surgery, short-term (first 2 years), intermediate-term (2-5 years), and long-term (>5 years) postsurgery care phases on the basis of treatment trajectory. Phase-specific and cumulative long-term health care costs were evaluated. Costs were converted from Canadian to US dollars year 2018 value. RESULTS There were 372 surgical and 258 medical patients. Costs were higher in surgical than medical patients for presurgery (3 and 39 weeks), surgery, and short-term care phase, and the attributable costs of surgery per 7 patient-days were $1,602 (95% CI $1,438-$1,785), $172 (95% CI $147-$185), $19,819 (95% CI $18,822-$20,932), and $28 (95% CI $22-$32), respectively. Costs were lower in surgical patients for intermediate- and long-term care phase, and the attributable costs were -$72 (95% CI -$124 to -$35) and -$94 (95% CI -$129 to -$63), respectively. In surgical patients, costs were highest for surgery followed by presurgery care phase, with hospitalizations accounting for the highest cost component. In medical patients, costs increased gradually from presurgery to long-term care phase. Cumulative costs were higher for surgical than medical patients in the first 7 years after surgery, but from 8 years on, costs were lower for surgical patients. DISCUSSION This study demonstrated the long-term economic benefits of epilepsy surgery compared to medical therapy for the health care system with the use of real-world data, which would justify the high costs of surgery. The results will support future economic evaluation comparing minimally invasive treatment such as laser therapy to surgery.
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Affiliation(s)
- Elysa Widjaja
- From the Institute of Health Policy, Management and Evaluation (E.W., A.G., G.T., B.H.S.) and Leong Centre for Healthy Children (A.G.), University of Toronto; Diagnostic Imaging (E.W.), Division of Neurology (E.W., O.C.S.), Neurosciences and Mental Health (L.D., O.Y.), Division of Pediatric Medicine (A.G.), and Department of Neurosurgery (J.R.), Hospital for Sick Children; ICES (E.W., A.G., B.H.S.); Toronto Health Economics and Technology Assessment (THETA) Collaborative (G.T., B.H.S.), University Health Network; and Public Health Ontario (B.H.S.), Toronto, Ontario, Canada.
| | - Lindsay Demoe
- From the Institute of Health Policy, Management and Evaluation (E.W., A.G., G.T., B.H.S.) and Leong Centre for Healthy Children (A.G.), University of Toronto; Diagnostic Imaging (E.W.), Division of Neurology (E.W., O.C.S.), Neurosciences and Mental Health (L.D., O.Y.), Division of Pediatric Medicine (A.G.), and Department of Neurosurgery (J.R.), Hospital for Sick Children; ICES (E.W., A.G., B.H.S.); Toronto Health Economics and Technology Assessment (THETA) Collaborative (G.T., B.H.S.), University Health Network; and Public Health Ontario (B.H.S.), Toronto, Ontario, Canada
| | - Omar Yossofzai
- From the Institute of Health Policy, Management and Evaluation (E.W., A.G., G.T., B.H.S.) and Leong Centre for Healthy Children (A.G.), University of Toronto; Diagnostic Imaging (E.W.), Division of Neurology (E.W., O.C.S.), Neurosciences and Mental Health (L.D., O.Y.), Division of Pediatric Medicine (A.G.), and Department of Neurosurgery (J.R.), Hospital for Sick Children; ICES (E.W., A.G., B.H.S.); Toronto Health Economics and Technology Assessment (THETA) Collaborative (G.T., B.H.S.), University Health Network; and Public Health Ontario (B.H.S.), Toronto, Ontario, Canada
| | - Astrid Guttmann
- From the Institute of Health Policy, Management and Evaluation (E.W., A.G., G.T., B.H.S.) and Leong Centre for Healthy Children (A.G.), University of Toronto; Diagnostic Imaging (E.W.), Division of Neurology (E.W., O.C.S.), Neurosciences and Mental Health (L.D., O.Y.), Division of Pediatric Medicine (A.G.), and Department of Neurosurgery (J.R.), Hospital for Sick Children; ICES (E.W., A.G., B.H.S.); Toronto Health Economics and Technology Assessment (THETA) Collaborative (G.T., B.H.S.), University Health Network; and Public Health Ontario (B.H.S.), Toronto, Ontario, Canada
| | - George Tomlinson
- From the Institute of Health Policy, Management and Evaluation (E.W., A.G., G.T., B.H.S.) and Leong Centre for Healthy Children (A.G.), University of Toronto; Diagnostic Imaging (E.W.), Division of Neurology (E.W., O.C.S.), Neurosciences and Mental Health (L.D., O.Y.), Division of Pediatric Medicine (A.G.), and Department of Neurosurgery (J.R.), Hospital for Sick Children; ICES (E.W., A.G., B.H.S.); Toronto Health Economics and Technology Assessment (THETA) Collaborative (G.T., B.H.S.), University Health Network; and Public Health Ontario (B.H.S.), Toronto, Ontario, Canada
| | - James Rutka
- From the Institute of Health Policy, Management and Evaluation (E.W., A.G., G.T., B.H.S.) and Leong Centre for Healthy Children (A.G.), University of Toronto; Diagnostic Imaging (E.W.), Division of Neurology (E.W., O.C.S.), Neurosciences and Mental Health (L.D., O.Y.), Division of Pediatric Medicine (A.G.), and Department of Neurosurgery (J.R.), Hospital for Sick Children; ICES (E.W., A.G., B.H.S.); Toronto Health Economics and Technology Assessment (THETA) Collaborative (G.T., B.H.S.), University Health Network; and Public Health Ontario (B.H.S.), Toronto, Ontario, Canada
| | - O Carter Snead
- From the Institute of Health Policy, Management and Evaluation (E.W., A.G., G.T., B.H.S.) and Leong Centre for Healthy Children (A.G.), University of Toronto; Diagnostic Imaging (E.W.), Division of Neurology (E.W., O.C.S.), Neurosciences and Mental Health (L.D., O.Y.), Division of Pediatric Medicine (A.G.), and Department of Neurosurgery (J.R.), Hospital for Sick Children; ICES (E.W., A.G., B.H.S.); Toronto Health Economics and Technology Assessment (THETA) Collaborative (G.T., B.H.S.), University Health Network; and Public Health Ontario (B.H.S.), Toronto, Ontario, Canada
| | - Beate Sander
- From the Institute of Health Policy, Management and Evaluation (E.W., A.G., G.T., B.H.S.) and Leong Centre for Healthy Children (A.G.), University of Toronto; Diagnostic Imaging (E.W.), Division of Neurology (E.W., O.C.S.), Neurosciences and Mental Health (L.D., O.Y.), Division of Pediatric Medicine (A.G.), and Department of Neurosurgery (J.R.), Hospital for Sick Children; ICES (E.W., A.G., B.H.S.); Toronto Health Economics and Technology Assessment (THETA) Collaborative (G.T., B.H.S.), University Health Network; and Public Health Ontario (B.H.S.), Toronto, Ontario, Canada
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Borrescio-Higa F, Valdés N. The Psychosocial Burden of Families with Childhood Blood Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010599. [PMID: 35010854 PMCID: PMC8744617 DOI: 10.3390/ijerph19010599] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 02/01/2023]
Abstract
Cancer is the second leading cause of death for children, and leukemias are the most common pediatric cancer diagnoses in Chile. Childhood cancer is a traumatic experience and is associated with distress, pain, and other negative experiences for patients and their families. Thus, psychosocial costs represent a large part of the overall burden of cancer. This study examines psychosocial experiences in a sample of 90 families of children with blood-related cancer in Chile. We provide a global overview of the family experience, focusing on patients, caregivers, and siblings. We find that most families report a negative impact upon diagnosis; disruptions in family dynamics; a range of negative feelings of the patient, such as depression, discouragement, and irritability; and difficulty with social lives. Additionally, they report negative effects in the relationship between the siblings of the patient and their parents, and within their caregivers' spouse/partner relationship, as well as a worsening of the economic condition of the primary caregiver. Furthermore, over half of the families in the sample had to move due to diagnosis and/or treatment. Promoting interventions that can help patients, siblings, and parents cope with distress and promote resilience and well-being are important.
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Rios JD, Velummailum R, Bennett J, Nobre L, Tsang DS, Bouffet E, Hawkins C, Tabori U, Denburg A, Pechlivanoglou P. Clinical and economic impact of molecular testing for BRAF fusion in pediatric low-grade Glioma. BMC Pediatr 2022; 22:13. [PMID: 34980048 PMCID: PMC8722113 DOI: 10.1186/s12887-021-03069-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Treatment personalization via tumor molecular testing holds promise for improving outcomes for patients with pediatric low-grade glioma (PLGG). We evaluate the health economic impact of employing tumor molecular testing to guide treatment for patients diagnosed with PLGG, particularly the avoidance of radiation therapy (RT) for patients with BRAF-fusion. Methods We performed a model-based cost-utility analysis comparing two strategies: molecular testing to determine BRAF fusion status at diagnosis against no molecular testing. We developed a microsimulation to model the lifetime health and cost outcomes (in quality-adjusted life years (QALYs) and 2018 CAD, respectively) for a simulated cohort of 100,000 patients newly diagnosed with PLGG after their initial surgery. Results The life expectancy after diagnosis for individuals who did not receive molecular testing was 39.01 (95% Confidence Intervals (CI): 32.94;44.38) years and 40.08 (95% CI: 33.19;45.76) years for those who received testing. Our findings indicate that patients who received molecular testing at diagnosis experienced a 0.38 (95% CI: 0.08;0.77) gain in QALYs and $1384 (95% CI: $-3486; $1204) reduction in costs over their lifetime. Cost and QALY benefits were driven primarily by the avoidance of long-term adverse events (stroke, secondary neoplasms) associated with unnecessary use of radiation. Conclusions We demonstrate the clinical benefit and cost-effectiveness of molecular testing in guiding the decision to provide RT in PLGG. While our results do not consider the impact of targeted therapies, this work is an example of the value of simulation modeling in assessing the long-term costs and benefits of precision oncology interventions for childhood cancer, which can aid decision-making about health system reimbursement. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-03069-1.
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Affiliation(s)
- Juan David Rios
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, 11th Floor - L4 East, Toronto, ON, M5G 0A4, Canada
| | - Russanthy Velummailum
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, 11th Floor - L4 East, Toronto, ON, M5G 0A4, Canada
| | - Julie Bennett
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Liana Nobre
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Derek S Tsang
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.,Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Eric Bouffet
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Cynthia Hawkins
- Department of Pathology, Hospital for Sick Children, Toronto, ON, Canada
| | - Uri Tabori
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Avram Denburg
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, 11th Floor - L4 East, Toronto, ON, M5G 0A4, Canada.,Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Petros Pechlivanoglou
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, 11th Floor - L4 East, Toronto, ON, M5G 0A4, Canada. .,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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de Oliveira C, Macpherson A, Hepburn CM, Huang A, Strauss R, Liu N, Fiksenbaum L, Pageau P, Gomez D, Saunders NR. Healthcare utilization and costs following non-fatal powdered and non-powdered firearm injuries for children and youth. Eur J Pediatr 2022; 181:2329-2342. [PMID: 35246737 PMCID: PMC9110444 DOI: 10.1007/s00431-022-04429-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 02/02/2023]
Abstract
Little is known about the healthcare and economic burdens of non-fatal firearm injuries for children/youth beyond the initial admission. This study sought to estimate healthcare utilization and total direct healthcare costs of non-fatal powdered and non-powdered (air gun) firearm injuries 1-year post-injury. Using administrative data from 2003 to 2018 on all children/youth 0-24 years old in Ontario, Canada, a matched 1:2 cohort study was conducted to compare children/youth who experienced powdered and non-powdered firearm injuries with those who did not. Mean and median number of healthcare encounters and costs, and respective 95% confidence intervals (CIs) and interquartile ranges (IQRs), were estimated for both weapon type groups and controls and by intent. Children/youth who experienced a powdered and non-powdered firearm injury had a higher number of healthcare encounters and costs per year than those who did not. Mean 1-year costs for those with powdered and non-powdered firearm injuries were $8825 ($8007-$9643) and $2349 ($2118-$2578), respectively, versus $812 ($567-$1058) and $753 ($594-$911), respectively, for those without. Mean 1-year costs were highest for handgun injuries ($12,875 [95% CI $9941-$15,808]), and for intentional assault-related ($13,498 [$11,843-$15,153]; $3287 [$2213-$4362]), and intentional self-injuries ($14,773 [$6893-$22,652]; $6005 [$2193-$9817]) for both powdered and non-powdered firearm injuries, respectively. Conclusion: Firearm injuries have substantial healthcare and economic burdens beyond the initial injury-related admission; this should be accounted for when examining the overall impact of firearm injuries. What is Known: • Child/youth firearm injuries have significant health and economic burdens. • However, existing work has mainly examined healthcare utilization and costs of initial admissions and/or have been limited to single-center studies and no studies have provide cost estimates by weapon type and intent. What is New: • Children/youth who suffered powdered firearm injuries had higher mean healthcare utilization and costs than those with non-powdered firearm injuries as well as comparable healthy children/youth. • Mean 1-year costs were highest for handgun injuries ($12,875), and for intentional assault-related ($13,498; $3287), and intentional self-injuries ($14,773; $6005) for powdered and non-powdered firearm injuries, respectively.
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Affiliation(s)
- Claire de Oliveira
- ICES, Toronto, Canada ,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada ,Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada ,Centre for Health Economics and Hull York Medical School, University of York, York, UK
| | - Alison Macpherson
- ICES, Toronto, Canada ,School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada
| | - Charlotte Moore Hepburn
- The Hospital for Sick Children, Toronto, ON Canada ,Department of Pediatrics, University of Toronto, Toronto, Canada ,Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | | | - Ning Liu
- ICES, Toronto, Canada ,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Lisa Fiksenbaum
- The Hospital for Sick Children, Toronto, ON Canada ,Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada
| | - Paul Pageau
- Department of Emergency Medicine, University of Ottawa, Ottawa, Canada
| | - David Gomez
- ICES, Toronto, Canada ,Temerty Faculty of Medicine, University of Toronto, Toronto, Canada ,Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada ,Division of General Surgery, St Michael’s Hospital, Unity Health Toronto, Toronto, Canada ,Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, Canada
| | - Natasha Ruth Saunders
- ICES, Toronto, Canada. .,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. .,The Hospital for Sick Children, Toronto, ON, Canada. .,Department of Pediatrics, University of Toronto, Toronto, Canada. .,Temerty Faculty of Medicine, University of Toronto, Toronto, Canada. .,Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada.
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Soliman R, Elhaddad A, Oke J, Eweida W, Tarek N, Hamza M, Yang Y, Abouelnaga S, Heneghan C. Childhood cancer hospital resource utilization and costs in Egypt, 2013-2017; patterns, trends, and associated factors for 8886 patients from Children's Cancer Hospital, Egypt. Pediatr Blood Cancer 2021; 68:e29347. [PMID: 34520099 DOI: 10.1002/pbc.29347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/14/2021] [Accepted: 08/23/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION There is a lack ofevidence about resource use and costs of childhood cancer care in Egypt. Knowledge about resource use/costs can help in better resource planning to improve care and outcomes efficiently. In this study, we estimated patterns and trends of hospital resource use and costs for children with cancer (n = 8886, aged 0-18 years) treated at Children's Cancer Hospital, Egypt (CCHE), between 2013 and 2017, by ICCC-3 groups, at one and three years post-diagnosis. METHODS We estimated costs from the healthcare provider perspective, expressed in USD 2019. We also studied resource use/cost trends, and factors associated with inpatient days and costs. RESULTS For all cancers combined, median costs were $14,774 (IQR: $6,559-$23,738) at one year and $19,799 (IQR: $8,921-$34,204) at three years post-diagnosis. Median inpatient days were 38 days (IQR: 17-60) at one year, and 43 days (IQR: 20-74) at three years post-diagnosis. Patients with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and neuroblastoma imposed the greatest financial burden on CCHE, representing 53.1% of total costs. AML patients had the highest costs/resource use of all childhood cancers. Cost trends decreased by 2.9% (P < 0.001) for all cancers combined, due to economic instability in Egypt between 2013 and 2017. The use of IV supportive drugs increased by 24.3% (P < 0.001) over time for children with solid tumors. CONCLUSION These findings will inform hospital resource planning and budgeting to promote value in care delivery, with implications for pediatric oncology practice and policy in Egypt/CCHE. Estimated costs provide the foundation for cost-effectiveness analysis.
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Affiliation(s)
- Ranin Soliman
- Department of Continuing Education, University of Oxford, Oxford, UK.,Health Economics and Value Unit, Children's Cancer Hospital, Egypt (CCHE), 57357, Egypt
| | - Alaa Elhaddad
- Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.,Pediatric Oncology Department, Children's Cancer Hospital, Egypt (CCHE), 57357, Egypt
| | - Jason Oke
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Wael Eweida
- Chief Operating Office, Children's Cancer Hospital, Egypt (CCHE), 57357, Egypt
| | - Nourhan Tarek
- Health Economics and Value Unit, Children's Cancer Hospital, Egypt (CCHE), 57357, Egypt
| | - Mahmoud Hamza
- Research Department, Children's Cancer Hospital, Egypt (CCHE), 57357, Egypt
| | - Yaling Yang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sherif Abouelnaga
- Pediatric Oncology Department, Children's Cancer Hospital, Egypt (CCHE), 57357, Egypt.,Chief Executive Office, Children's Cancer Hospital, Egypt (CCHE), 57357, Egypt
| | - Carl Heneghan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Tan O, Schofield DJ, Shrestha R. An Analysis of Hospital Costs for Childhood Cancer Care. J Natl Compr Canc Netw 2021; 20:126-135. [PMID: 34359019 DOI: 10.6004/jnccn.2020.7802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 12/23/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study used a linked dataset consisting of all childhood cancers recorded over the course of 10 years in New South Wales (NSW), Australia, to evaluate the hospital and emergency department costs (from a payer perspective) and resources used by patients with childhood cancer. We also analyzed determinants responsible for high-frequency hospital admissions, hospital length of stay (LoS), and hospital costs. METHODS We analyzed linked data at the individual patient level for a retrospective cohort of 2,966 patients with cancer aged <18 years with a diagnosis date between 2001 and 2012 from the NSW Central Cancer Registry, Australia. We reported costs and use of hospitalization and emergency department presentation 1 year before the date of diagnosis, 1 year after diagnosis, and 2 to 5 years after diagnosis. We also examined the association between cancer types and hospital admission and hospital costs from the payer perspective. Patient characteristics associated with the frequency of hospital admissions, hospital LoS, and hospital costs were also determined using a generalized linear model. RESULTS Most hospital admission costs occurred in the first year after diagnosis, accounting for >70% of hospital costs within 5 years after diagnosis. The estimated median annual cost of hospitalization in the first year after diagnosis was A$88,964 (interquartile range [IQR], A$34,399-A$163,968) for patients diagnosed at age 0 to 14 years and A$23,384 (IQR, A$5,585-A$91,565) for those diagnosed at age 15 to 17 years. Higher frequency of hospital admissions, hospital LoS, and hospital costs were significantly associated with younger age at cancer diagnosis, cancer metastases, and living in remote/disadvantaged socioeconomic areas. CONCLUSIONS Our study represents one of the first in Australia to include detailed hospitalization cost information for all childhood cancer cases. This study highlights the high hospital use by pediatric patients and the importance of early diagnosis. Our findings also demonstrate the health inequities experienced by patients from remote areas and the lowest socioeconomic areas.
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Affiliation(s)
- Owen Tan
- 1GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, Sydney, Australia
| | - Deborah J Schofield
- 1GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, Sydney, Australia
| | - Rupendra Shrestha
- 1GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, Sydney, Australia
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Medical Cost of Cancer Care for Privately Insured Children in Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136746. [PMID: 34201571 PMCID: PMC8267683 DOI: 10.3390/ijerph18136746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/12/2021] [Accepted: 06/19/2021] [Indexed: 11/27/2022]
Abstract
Medical care for children with cancer is complex and expensive, and represents a large financial burden for families around the world. We estimated the medical cost of cancer care for children under the age of 18, using administrative records of the universe of children with private insurance in Chile in the period 2007–2018, based on a sample of 3853 observations. We analyzed total cost and out-of-pocket spending by patients’ characteristics, type of cancer, and by service. Children with cancer had high annual medical costs, USD 32,287 on average for 2018. Costs were higher for the younger children in the sample. The vast majority of the cost was driven by inpatient hospital care for all types of cancer. The average total cost increased 20% in real terms over the period of study, while out-of-pocket expenses increased almost 29%. Private insurance beneficiaries faced a significant economic burden associated with medical treatment of a child with cancer. Interventions that reduce hospitalizations, as well as systemwide reforms that incorporate maximum out-of-pocket payments and prevent catastrophic expenditures, can contribute to alleviating the financial burden of childhood cancer.
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Widjaja E, Guttmann A, Tomlinson G, Snead OC, Sander B. Economic burden of epilepsy in children: A population-based matched cohort study in Canada. Epilepsia 2020; 62:152-162. [PMID: 33258123 DOI: 10.1111/epi.16775] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The economic burden of childhood epilepsy to the health care system remains poorly understood. This study aimed to determine phase-specific and cumulative long-term health care costs in children with epilepsy (CWE) from the health care payer perspective. METHODS This cohort study utilized linked health administrative databases in Ontario, Canada. Incident childhood epilepsy cases were identified from January 1, 2003 to June 30, 2017. CWE were matched to children without epilepsy (CWOE) on age, sex, rurality, socioeconomic status, and comorbidities, and assigned prediagnosis, initial, ongoing, and final care phase based on clinical trajectory. Phase-specific, 1-year and 5-year cumulative health care costs, attributable costs of epilepsy, and distribution of costs across different ages were evaluated. RESULTS A total of 24 411 CWE were matched to CWOE. The costs were higher for prediagnosis and initial care than ongoing care in CWE. Hospitalization was the main cost component. The costs of prediagnosis, initial, and ongoing care were higher in CWE than CWOE, with the attributable costs at $490 (95% confidence interval [CI] = $352-$616), $1322 (95% CI = $1247-$1402), and $305 (95% CI = $276-$333) per 30 patient-days, respectively. Final care costs were lower in CWE than CWOE, with attributable costs at -$2515 (95% CI = -$6288 to $961) per 30 patient-days. One-year and 5-year cumulative costs were higher in CWE ($14 776 [95% CI = $13 994-$15 546] and $39 261 [95% CI = $37 132-$41 293], respectively) than CWOE ($6152 [95% CI = $5587-$6768] and $15 598 [95% CI = $14 291-$17 006], respectively). The total health care costs were highest in the first year of life in CWE for prediagnosis, initial, and ongoing care. SIGNIFICANCE Health care costs varied along the continuum of epilepsy care, and were mainly driven by hospitalization costs. The findings identified avenues for remediation, such as enhancing care around the time of epilepsy diagnosis and better care coordination for epilepsy and comorbidities, to reduce hospitalization costs and the economic burden of epilepsy care.
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Affiliation(s)
- Elysa Widjaja
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Division of Neurology, Hospital for Sick Children, Toronto, ON, Canada.,ICES, Toronto, ON, Canada
| | - Astrid Guttmann
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada.,Leong Centre for Healthy Children, University of Toronto, ON, Canada
| | - George Tomlinson
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, University Health Network, Toronto, ON, Canada
| | - O Carter Snead
- Division of Neurology, Hospital for Sick Children, Toronto, ON, Canada
| | - Beate Sander
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, University Health Network, Toronto, ON, Canada.,Public Health Ontario, Toronto, ON, Canada
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11
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Jiang C, Cai S, Duan C, Xu N, Zhou Y, Peng X, Ma X. Analysis of treatment cost for neuroblastoma to the family: a single-center cross-sectional study in China. J Med Econ 2020; 23:961-966. [PMID: 32568600 DOI: 10.1080/13696998.2020.1786392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Neuroblastoma (NB) is notorious in childhood cancer because of its high incidence and poor prognosis. The Children's Oncology Group reported that the 3-year OS in the high-risk (HR) group is 50%, and the HR-NB with bone marrow metastasis in our center is 43.1%. Thousands of families in China suffer from the cost of NB, but the true costs of therapy are unknown; to date, no study has ever performed a detailed therapy costs analysis for NB. The objective of this study was to assess the economic burden of NB treatment in children to the family, to ultimately reduce related expenses for patients and promote the establishment of NB management policy. MATERIALS AND METHODS Data in this cross-sectional study were collected via questionnaires completed by parents at the outpatient clinic and was verified via a computer system. Therapy costs of children with NB of differing risks were analyzed through descriptive statistics (1 CNY ≈ 0.1412 USD). RESULTS Median direct medical costs of low risk (LR), middle risk (MR), and HR NB during treatment were 180.0 (120.0, 300.0), 200.0 (166.0, 300.0), and 650.0 (415.5, 850.0) thousand Chinese yuan (CNY), respectively. Direct non-medical costs including transportation, food, and accommodation were 60.0 (37.0, 100.0), 80.0 (60.0, 120.0), and 100.0 (80.0, 157.5) thousand CNY in the LR, MR, and HR groups, respectively. Additionally, parents accrued work absences to attend treatment, and lost a total of 100.0 (50.0, 150.0) thousand CNY in indirect costs. LIMITATIONS Families whose children had relapsed or died were excluded from this analysis and therefore limited the conclusions drawn. Parents were asked to recall costs since initial diagnosis (1-6 years in the past), but this extended time period may have introduced recall bias. CONCLUSIONS Direct non-medical and indirect costs play an important role in the total treatment costs of NB. Children with NB treated in local hospitals and followed up in hospital specialized in childhood oncology may save many unnecessary expenses. China's healthcare system should establish mechanisms and provide financial support for children with NB.
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Affiliation(s)
- Chiyi Jiang
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Siyu Cai
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Chao Duan
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Na Xu
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yuchen Zhou
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaoxia Peng
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaoli Ma
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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12
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Merollini KMD, Gordon LG, Aitken JF, Kimlin MG. Lifetime Costs of Surviving Cancer-A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082831. [PMID: 32326074 PMCID: PMC7216287 DOI: 10.3390/ijerph17082831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/17/2020] [Accepted: 04/18/2020] [Indexed: 12/15/2022]
Abstract
Australia-wide, there are currently more than one million cancer survivors. There are over 32 million world-wide. A trend of increasing cancer incidence, medical innovations and extended survival places growing pressure on healthcare systems to manage the ongoing and late effects of cancer treatment. There are no published studies of the long-term health service use and cost of cancer survivorship on a population basis in Australia. All residents of the state of Queensland, Australia, diagnosed with a first primary malignancy from 1997–2015 formed the cohort of interest. State and national healthcare databases are linked with cancer registry records to capture all health service utilization and healthcare costs for 20 years (or death, if this occurs first), starting from the date of cancer diagnosis, including hospital admissions, emergency presentations, healthcare costing data, Medicare services and pharmaceuticals. Data analyses include regression and economic modeling. We capture the whole journey of health service contact and estimate long-term costs of all cancer patients diagnosed and treated in Queensland by linking routinely collected state and national healthcare data. Our results may improve the understanding of lifetime health effects faced by cancer survivors and estimate related healthcare costs. Research outcomes may inform policy and facilitate future planning for the allocation of healthcare resources according to the burden of disease.
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Affiliation(s)
- Katharina M. D. Merollini
- Sunshine Coast Health Institute, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia;
- Correspondence: ; Tel.: +61 7 5202 3159
| | - Louisa G. Gordon
- QIMR Berghofer, Medical Research Institute, Herston, QLD 4006, Australia;
- School of Nursing, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Joanne F. Aitken
- Cancer Council Queensland, Fortitude Valley, QLD 4006, Australia;
- Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD 4305, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia
| | - Michael G. Kimlin
- Sunshine Coast Health Institute, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia;
- School of Biomedical Sciences, Queensland University of Technology, St Lucia, QLD 4072, Australia
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13
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McBride ML, de Oliveira C, Duncan R, Bremner KE, Liu N, Greenberg ML, Nathan PC, Rogers PC, Peacock SJ, Krahn MD. Comparing Childhood Cancer Care Costs in Two Canadian Provinces. ACTA ACUST UNITED AC 2020; 15:76-88. [PMID: 32176612 PMCID: PMC7075448 DOI: 10.12927/hcpol.2020.26129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Cancer in children presents unique issues for diagnosis, treatment and survivorship care. Phase-specific comparative cost estimates are important for informing healthcare planning. Objectives: The aim of this paper is to compare direct medical costs of childhood cancer by phase of care in British Columbia (BC) and Ontario (ON). Methods: For cancer patients diagnosed at <15 years of age and propensity-score-matched non-cancer controls, we applied standard costing methodology using population-based healthcare administrative data to estimate and compare phase-based costs by province. Results: Phase-specific cancer-attributable costs were 2%–39% higher for ON than for BC. Leukemia pre-diagnosis costs and annual lymphoma continuing care costs were >50% higher in ON. Phase-specific in-patient hospital costs (the major cost category) represented 63%–82% of ON costs, versus 43%–73% of BC costs. Phase-specific diagnostic tests and procedures accounted for 1.0%–3.4% of ON costs and 2.8%–13.0% of BC costs. Conclusions: There are substantial cost differences between these two Canadian provinces, BC and ON, possibly identifying opportunities for healthcare planning improvement.
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Affiliation(s)
- Mary L McBride
- Emerita Scientist, Cancer Control Research, British Columbia Cancer, Vancouver, BC
| | - Claire de Oliveira
- Independent Scientist and Health Economist, Center for Addiction and Mental Health, Toronto, ON
| | - Ross Duncan
- Graduate Student, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC
| | - Karen E Bremner
- Research Associate, Toronto General Hospital Research Institute, University Health Network, Toronto, ON
| | - Ning Liu
- Senior Research Analyst, Institute for Clinical Evaluative Sciences, Toronto, ON
| | - Mark L Greenberg
- Chair in Childhood Cancer Control and Professor of Paediatrics and Surgery, Pediatric Oncology Group of Ontario, Toronto, ON
| | - Paul C Nathan
- Staff Oncologist and Director, Aftercare Program, The Hospital for Sick Children, Toronto, ON
| | - Paul C Rogers
- Clinical Professor, Division of Hematology, Oncology & Bone Marrow Transplant, BC Children's Hospital, Vancouver, BC
| | - Stuart J Peacock
- Distinguished Scientist, Leslie Diamond Chair in Cancer Survivorship, Cancer Control Research, British Columbia Cancer, Vancouver, BC
| | - Murray D Krahn
- Senior Scientist and Director, THETA Collaborative, Toronto General Hospital Research Institute, University Health Network, Toronto, ON
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Abdeen N, Naz F, Linthorst R, Khan U, Dominguez PC, Koujok K, Bettoli M, Shenouda N. Clinical impact and cost‐effectiveness of noncontrast MRI in the evaluation of suspected appendiceal abscesses in children. J Magn Reson Imaging 2019; 49:e241-e249. [DOI: 10.1002/jmri.26624] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/02/2018] [Accepted: 12/03/2018] [Indexed: 12/29/2022] Open
Affiliation(s)
- Nishard Abdeen
- Department of Medical ImagingChildren's Hospital of Eastern Ontario Ottawa Ontario Canada
| | - Fozia Naz
- Department of Medical ImagingChildren's Hospital of Eastern Ontario Ottawa Ontario Canada
| | - Rhys Linthorst
- Faculty of MedicineMcMaster University Hamilton Ontario Canada
| | - Usman Khan
- Faculty of MedicineUniversity of Ottawa Ontario Canada
| | - Pablo Caro Dominguez
- Department of Medical ImagingChildren's Hospital of Eastern Ontario Ottawa Ontario Canada
| | - Khaldoun Koujok
- Department of Medical ImagingChildren's Hospital of Eastern Ontario Ottawa Ontario Canada
| | - Marcos Bettoli
- Department of SurgeryChildren's Hospital of Eastern Ontario Ottawa Ontario Canada
| | - Nazih Shenouda
- Department of Medical ImagingChildren's Hospital of Eastern Ontario Ottawa Ontario Canada
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15
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Yu H, Zhang H, Yang J, Liu C, Lu C, Yang H, Huang W, Zhou J, Fu W, Shi L, Yan Y, Liu G, Li L. Health utility scores of family caregivers for leukemia patients measured by EQ-5D-3L: a cross-sectional survey in China. BMC Cancer 2018; 18:950. [PMID: 30285666 PMCID: PMC6171222 DOI: 10.1186/s12885-018-4855-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 09/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study assessed the health related quality of life of family caregivers (FCs) of leukemia patients by using the health utility scores derived from the EuroQol five-dimensional (EQ-5D) questionnaire. METHODS A cross-sectional survey was undertaken on 306 family caregivers of leukemia patients to assess their health utility using the EQ-5D-3L. Participants were recruited from three hospitals in China's Heilongjiang province. The health utility scores of the participants were estimated based on the Chinese EQ-5D-3L value set and compared with those of the local general population. Factors predicting the health utility scores were identified through the Kruskal-Wallis analysis of variance and median regression analyses. RESULTS FCs had lower health utility scores than the general population (p < 0.001). The participants with a lower socioeconomic status had lower utility scores and reported more problems than those with a higher socio-economic status. Better family function and higher social support were associated with higher health utility scores. The type of leukemia, household income, and social support are significant predictors of health utility scores of the FCs. Chronic lymphocytic leukemia, low socio-economic status, and low social support are associated with lower health utility scores of the FCs. CONCLUSIONS FCs for leukemia patients have lower health utility scores than the local general population, as measured by the EQ-5D-3L. There is an immediate need to address the health concerns of FCs, who play an important role in the Chinese health care system.
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Affiliation(s)
- Hongjuan Yu
- The First Affiliated Hospital of Harbin Medical University, Harbin, 150081, China
| | - Huan Zhang
- Affiliate Tumor Hospital of Harbin Medical University, Harbin, 150000, China
| | - Jinjin Yang
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Chengfang Lu
- The First Affiliated Hospital of Harbin Medical University, Harbin, 150081, China
| | - Hongbin Yang
- Affiliate Tumor Hospital of Harbin Medical University, Harbin, 150000, China
| | - Weidong Huang
- School of Health Management, Harbin Medical University, Harbin, 150086, China.
| | - Jin Zhou
- The First Affiliated Hospital of Harbin Medical University, Harbin, 150081, China
| | - Wenqi Fu
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Linmei Shi
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Yan Yan
- Heilongjiang Provincial Hospital, Harbin, 150081, China
| | - Guoxiang Liu
- School of Health Management, Harbin Medical University, Harbin, 150086, China.
| | - Limin Li
- The First Affiliated Hospital of Harbin Medical University, Harbin, 150081, China.
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