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Oral cancer treatment costs in Greece and the effect of advanced disease.

Zavras A, Andreopoulos N, Katsikeris N, Zavras D, Cartsos V, Vamvakidis A - BMC Public Health (2002)

Bottom Line: Another aim was to identify factors that affect costs and potential cost reduction items.Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05).Disease stage was also associated with the total duration of hospitalization (p < 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Policy & Epidemiology,Harvard School of Dental Medicine, 118 Longwood Avenue, Boston, MA 02115, USA. zavras@hms.harvard.edu

ABSTRACT

Background: The main purpose of the study was to quantify the direct costs of oral cancer treatment to the healthcare system of Greece. Another aim was to identify factors that affect costs and potential cost reduction items. More specifically, we examined the relationship between stage of disease, modality of treatment and total direct costs.

Methods: The medical records and clinic files of the Oral and Maxillofacial Clinic of the Athens General Hospital "Genimatas" were abstracted to investigate clinical treatment characteristics, including length of hospitalization, modes of treatment, stage of disease etc. Records of 95 patients with oral squamous cell carcinoma (OSSC), with at least six months of follow-up, were examined. The clinical data was then used to calculate actual direct costs, based on 2001 market values.

Results: The mean total direct costs for OSSC treatment estimated at euro 8,450 or approximately US$ 7,450. Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05). Multi-modality treatment applied mainly to patients in stages III and IV was the factor that affected the cost. Disease stage was also associated with the total duration of hospitalization (p < 0.05).

Conclusions: The clinical management of advanced oral cancer is strongly associated with higher costs. Although the ideal would be to prevent cancer, the combination of high-risk screening, early diagnosis and early treatment seems the most efficient way to reduce costs, and most importantly, prolong life.

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Related in: MedlinePlus

Mean length of hospitalization (in days) and cost* per patient, stratified by disease stage * expressed in US$ thousand (pictured in relative scale)
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Figure 2: Mean length of hospitalization (in days) and cost* per patient, stratified by disease stage * expressed in US$ thousand (pictured in relative scale)

Mentions: Regarding the variation of inpatient hospitalization, it was observed that disease stage was associated with the total duration of hospitalization (Figure 2). This was confirmed by the statistical analysis. Hospitalization did not differ significantly between stages I and II. However, hospitalization was found to be significantly prolonged in stage III (p < 0.01) and IV (p < 0.01) as compared to stage 1. In addition, the variation in hospitalization length was found associated with the mode of treatment, with radiation therapy (p < 0.01) and chemotherapy (p < 0.01) being predictors of prolonged stay. Surgery was not found to be significantly associated with prolonged hospitalization.


Oral cancer treatment costs in Greece and the effect of advanced disease.

Zavras A, Andreopoulos N, Katsikeris N, Zavras D, Cartsos V, Vamvakidis A - BMC Public Health (2002)

Mean length of hospitalization (in days) and cost* per patient, stratified by disease stage * expressed in US$ thousand (pictured in relative scale)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC117788&req=5

Figure 2: Mean length of hospitalization (in days) and cost* per patient, stratified by disease stage * expressed in US$ thousand (pictured in relative scale)
Mentions: Regarding the variation of inpatient hospitalization, it was observed that disease stage was associated with the total duration of hospitalization (Figure 2). This was confirmed by the statistical analysis. Hospitalization did not differ significantly between stages I and II. However, hospitalization was found to be significantly prolonged in stage III (p < 0.01) and IV (p < 0.01) as compared to stage 1. In addition, the variation in hospitalization length was found associated with the mode of treatment, with radiation therapy (p < 0.01) and chemotherapy (p < 0.01) being predictors of prolonged stay. Surgery was not found to be significantly associated with prolonged hospitalization.

Bottom Line: Another aim was to identify factors that affect costs and potential cost reduction items.Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05).Disease stage was also associated with the total duration of hospitalization (p < 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Policy & Epidemiology,Harvard School of Dental Medicine, 118 Longwood Avenue, Boston, MA 02115, USA. zavras@hms.harvard.edu

ABSTRACT

Background: The main purpose of the study was to quantify the direct costs of oral cancer treatment to the healthcare system of Greece. Another aim was to identify factors that affect costs and potential cost reduction items. More specifically, we examined the relationship between stage of disease, modality of treatment and total direct costs.

Methods: The medical records and clinic files of the Oral and Maxillofacial Clinic of the Athens General Hospital "Genimatas" were abstracted to investigate clinical treatment characteristics, including length of hospitalization, modes of treatment, stage of disease etc. Records of 95 patients with oral squamous cell carcinoma (OSSC), with at least six months of follow-up, were examined. The clinical data was then used to calculate actual direct costs, based on 2001 market values.

Results: The mean total direct costs for OSSC treatment estimated at euro 8,450 or approximately US$ 7,450. Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05). Multi-modality treatment applied mainly to patients in stages III and IV was the factor that affected the cost. Disease stage was also associated with the total duration of hospitalization (p < 0.05).

Conclusions: The clinical management of advanced oral cancer is strongly associated with higher costs. Although the ideal would be to prevent cancer, the combination of high-risk screening, early diagnosis and early treatment seems the most efficient way to reduce costs, and most importantly, prolong life.

Show MeSH
Related in: MedlinePlus