Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Factors impacting hospitalisation and related health service costs in cancer survivors in Australia: results from a population data linkage study in Queensland (#453)

Katharina Merollini 1 2 , Louisa Collins 3 4 , Andrew Jones 5 , Joanne Aitken 6 7 , Michael Kimlin 8
  1. University of the Sunshine Coast, Sippy Downs, Queensland, Australia
  2. Sunshine Coast Health Institute, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  3. Health Economics, QIMR Berghofer Research Institute, Herston, Queensland, Australia
  4. School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
  5. Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
  6. Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
  7. School of Public Health, University of Queensland, Herston, Queensland, Australia
  8. Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia

Aims

The global economic cost of cancer and ongoing care costs for survivors are increasing. Little is known about factors affecting hospitalisations and related costs for the growing number of cancer survivors. Our aim was to identify contributing factors of cancer survivors admitted to hospital in the public system and their costs from a health services perspective. 

Methods 

A population-based, retrospective, data linkage study was conducted in Queensland (COS-Q), Australia, including individuals diagnosed with a first primary cancer (1997-2015) and incurred healthcare costs between 2013-2016. Generalised linear models were fitted to explore associations between socio-demographic (age, sex, country of birth, marital status, occupation, geographic remoteness category, socio-economic index) and clinical factors (cancer type, year of / time since diagnosis, vital status, care type) with mean annual hospital costs and mean episode costs. 

Results

Of the cohort (N=230,380) 48.5% (n=111,820) incurred hospitalisations in the public system (n=682,483 admissions). Hospital costs were highest for individuals who died during the costing period (cost ratio ‘CR’: 1.79, p<0.001) or living in very remote or remote location (CR: 1.71 and CR: 1.36, P<0.001) or aged 0-24 years (CR: 1.63, p<0.001). Episode costs were highest for individuals in rehabilitation or palliative care (CR: 2.94 and CR: 2.34, P<0.001), or very remote location (CR: 2.10, p<0.001). Higher contributors to overall hospital costs were ‘diseases and disorders of the digestive system’ (AU$661m, 21% of admissions) and ‘neoplastic disorders’ (AU$554m, 20% of admissions). 

Conclusions

We identified a range of factors contributing to hospitalisation and higher hospital costs for cancer survivors and our results clearly demonstrate very high public health costs of hospitalisation. There is a lack of obvious means to reduce these costs in the short or medium term which emphasises an increasing economic imperative to improving cancer prevention and investments in home- or community-based patient support services.