Healthcare resource utilization in the management of oesophageal adenocarcinoma

Citation
A. Soni et A. Sonnenberg, Healthcare resource utilization in the management of oesophageal adenocarcinoma, ALIM PHARM, 15(7), 2001, pp. 945-951
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pharmacology,"da verificare
Journal title
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN journal
0269-2813 → ACNP
Volume
15
Issue
7
Year of publication
2001
Pages
945 - 951
Database
ISI
SICI code
0269-2813(200107)15:7<945:HRUITM>2.0.ZU;2-W
Abstract
Objective: To study the natural history of oesophageal adenocarcinoma in te rms of utilization of the healthcare resources and associated medical costs . Methods: All 29 patients treated at the University of New Mexico Health Cen ter between 1 January 1992 and 1 December 1998 for an oesophageal adenocarc inoma were included in the study. For each individual patient, all medical resources utilized, facility costs, and physician fees were retrieved from the computerized databases of the collection departments. Results: During the progress of the disease, the same type of diagnostic or therapeutic procedure became necessary a number of times, and patients und erwent, on average, three (range one to eight) upper gastrointestinal endos copies, five (range one to 11) computerized tomography scans, 35 (five to 1 43) X-ray examinations, and 28 (three to 46) radiation therapies or 39 (10 to 74) chemotherapies. The large variation in the numbers of resources util ized was also reflected by a corresponding variation in total healthcare co sts. The mean cost per patient was $48 127, ranging between $13 454 and $13 9 721. Facility costs comprised 88% of all costs compared to physician fees which comprised 12%. The largest cost items, in declining order, were phys ician encounters ($16 916), radiation plus chemotherapy ($9909 plus $4891, respectively), and pharmacy prescriptions ($7565). Conclusions: The prolonged disease process and the many diagnostic and ther apeutic procedures result in complications, side-effects, inconclusive test s, or failed therapies that all markedly increase the use of healthcare res ources. Because such outcomes are the rule rather than the exception, the m anagement of oesophageal adenocarcinoma is expensive.