Exploring the Costs of Hospital and Emergency Department Utilisation in the First Three Years After Diagnosis for Adults Diagnosed With Pancreatic Cancer in Queensland, Australia

Abstract

Objective

To quantify costs incurred by the health system for hospital episodes and emergency department (ED) presentations for pancreatic cancer patients within the first three years after diagnosis in Queensland, Australia.

Study Settings and Design

Using a linked administrative dataset, CancerCostMod, which includes cancer diagnoses from the Queensland Cancer Registry (1st July 2011–30th June 2015) and linked Queensland Health Admitted Patient Data Collection and ED Information Systems records (1st July 2011–30th June 2018), we assessed costs for adults diagnosed with primary pancreatic cancer (International Classification of Diseases, 10th Revision: C25). Costs (in Australian dollars) were assigned using national public costs and private hospital charge datasets for the relevant year. Descriptive analyses were conducted to evaluate hospital and ED utilization and costs. Cost variations across sociodemographic and clinical characteristics were assessed using Kruskal–Wallis or Mann–Whitney U tests.

Principal Findings

Among 2082 individuals diagnosed with pancreatic cancer, hospital episodes (n = 26,405) in the first three years after diagnosis cost a total of $100.7 million; median cost per patient was $36,832. For ED presentations (n = 4228), corresponding figures were $3.6 million (total) and $963 (median per patient). Most of the total hospital (81%) and ED (79%) costs occurred in the first year after diagnosis. Patients who survived ≤ 6 months had the lowest median cost per patient but accounted for 38% of total hospital costs. Median cost per patient varied substantially by socio-demographic (i.e., Age groups, Indigenous status, socio-economic disadvantages) and clinical characteristics (i.e., comorbidity, cancer morphology, location of tumor, tumor resection, palliative care).

Conclusions

Our findings highlight the significant economic burden of pancreatic cancer on the healthcare system, especially within the first year. Targeted strategies are essential to optimize healthcare delivery, ensure equitable access, and improve outcomes.