Dataset Information

Global comparison of cancer outcomes: standardization and correlation with healthcare expenditures.

ABSTRACT:

Background

Cancer outcomes vary widely among different countries. However, comparisons of cost-effectiveness and cost-efficiency of different systems are complex because the incidences of different cancers vary across countries and their chances of cure also differ substantially. We aim to propose a new standardized method for global comparison and to explore its relationship with economic indicators.

Methods

Cancer statistics from all 184 countries and 27 cancers listed in GLOBOCAN 2012 were analyzed. The complement of age-standardized mortality/incidence ratio [1 - (ASM/ASI)] was taken as the proxy relative survival (RS). Accounting for various country-specific cancer patterns, the cancer site-standardized proxy RS (proxy SS-RS) of individual countries were calculated by weighting the proportion of specific cancer sites as compared with the global pattern of incidence. Economic indicators of different countries listed by the World Bank were correlated with corresponding proxy SS-RS.

Results

Substantial variation in site-specific survival and new case distribution supported the use of proxy SS-RS, which ranged from 0.124 to 0.622 (median 0.359). The median total health expenditure per capita (HEpc) increased from US$44 for countries with proxy SS-RS ConclusionsSimilar to age-standardization, cancer site-standardization adjusted for variation in pattern of cancer incidence provides the best available and feasible strategies for comparing cancer survivals across countries globally. Furthermore, cancer outcome correlated significantly with economic indicators and the amount of HEpc escalated exponentially. Our findings call for more in-depth studies applying cancer-site standardization to provide essential data for sharing of experience and urgent actions by policy makers to develop comprehensive and financially sustainable cancer plan for greater equity.

SUBMITTER: Choi HCW

PROVIDER: S-EPMC6686500 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Global comparison of cancer outcomes: standardization and correlation with healthcare expenditures.

Choi Horace C W HCW Lam Ka-On KO Pang Herbert H M HHM Tsang Steven K C SKC Ngan Roger K C RKC Lee Anne W M AWM

BMC public health 20190807 1

<h4>Background</h4>Cancer outcomes vary widely among different countries. However, comparisons of cost-effectiveness and cost-efficiency of different systems are complex because the incidences of different cancers vary across countries and their chances of cure also differ substantially. We aim to propose a new standardized method for global comparison and to explore its relationship with economic indicators.<h4>Methods</h4>Cancer statistics from all 184 countries and 27 cancers listed in GLOBOC ...[more]

PMID: 31391013

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Project description:BackgroundsA desire for better outcome influences cancer patients' willingness to pay. Whilst cancer-related costs are known to have a u-shaped distribution, the actual level of healthcare utilized by patients may vary depending on income and ability to pay. This study examined patterns of healthcare expenditures in the last year of life in patients with gastric, colorectal, lung, and liver cancer and analyzed whether differences exist in the level of end-of-life costs for cancer care according to economic status.MethodsThis study is a retrospective cohort study which used data from the Korean National Elderly Sampled Cohort, 2002 to 2015. End-of-life was defined as 1 year before death. Economic status was classified into three categorical variables according to the level of insurance premium (quantiles). The relationship between the dependent and independent variables were analyzed using multiple gamma regression based on the generalized estimated equation (GEE) model.ResultsThis study included 3083 cancer patients, in which total healthcare expenditure was highest in the high-income group. End-of-life costs increased the most in the last 3 months of life. Compared to individuals in the 'middle' economic status group, those in the 'high' economic status group (RR 1.095, 95% CI 1.044-1.149) were likely to spend higher amounts. The percentage of individuals visiting a general hospital was highest in the 'high' economic status group, followed by the 'middle' and 'low' economic status groups.ConclusionHealthcare costs for cancer care increased at end-of-life in Korea. Patients of higher economic status tended to spender higher amounts of end-of-life costs for cancer care. Further in-depth studies are needed considering that end-of-life medical costs constitute a large proportion of overall expenditures. This study offers insight by showing that expenditures for cancer care tend to increase noticeably in the last 3 months of life and that differences exist in the amount spent according economic status.

Dataset Information

Global comparison of cancer outcomes: standardization and correlation with healthcare expenditures.

Background

Methods

Results

Publications

Global comparison of cancer outcomes: standardization and correlation with healthcare expenditures.

Similar Datasets

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