Hospitalisation costs of sinonasal cancer: Results from the Italian hospital discharge registry (2001–2018)

Objective: This paper assesses hospital costs associated with sinonasal cancer (SNC) in Italy and evaluates related time trends.Methods: All Italian hospitalizations treating patients with a diagnosis of SNC (N = 29,355) were extracted from the National Hospital Discharge Registry. Data refer to patients discharged from public and private hospitals between 2001 and 2018. Hospitalization cost, admission rate, length of stay and other hospitalization-level variables were used as the main outcome variables. Information on the relative disease intensity per hospitalization was used to specifically allocate total hospitalization costs to SNC medical resources.Results: Over the 2001-2018 period, Italian hospitals have treated 1,631 admissions with SNC every year, on average. The mean annual hospitalization cost across all hospitals was 5,502,909 €, or 3,374 € per admission, and 60.0% of these costs were attributable to SNC only. Patient age at discharge (from 62 to 63 years), percentage of surgical procedures (from 29.3% to 46.8%) and of urgent cases (from 13.5% to 16.5%) increased over time. The percentage of costs attributable to SNC followed an inverted U-shaped pattern reaching the minimum level in 2006; conversely, mortality rose until 2007 then decreased steadily.Conclusions: Good progress has been made in SNC treatments. Endoscopic techniques represent one of the most important advances in this field, reducing morbidity and hospital length of stay while keeping similar survival rates. Policies aimed at monitoring workers most exposed to SNC risk and at standardizing hospital treatments could help Public Health Institutions to plan optimal prevention policies.