Keratinocyte cancer excisions in Australia: Who performs them and associated costs.
Ambulatory Surgical Procedures
/ economics
Australia
/ epidemiology
Carcinoma, Basal Cell
/ economics
Carcinoma, Squamous Cell
/ economics
Dermatologists
/ statistics & numerical data
Female
Hospitals, Private
/ statistics & numerical data
Hospitals, Public
/ statistics & numerical data
Humans
Male
Middle Aged
National Health Programs
/ economics
Operating Rooms
/ economics
Physicians, Primary Care
/ statistics & numerical data
Skin Neoplasms
/ economics
Surgeons
/ statistics & numerical data
costs
health services
hospitalisation
keratinocytes
physicians
skin neoplasm
Journal
The Australasian journal of dermatology
ISSN: 1440-0960
Titre abrégé: Australas J Dermatol
Pays: Australia
ID NLM: 0135232
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
14
01
2019
accepted:
24
03
2019
pubmed:
24
4
2019
medline:
14
4
2020
entrez:
24
4
2019
Statut:
ppublish
Résumé
To describe the clinical settings in which keratinocyte cancers are excised in Queensland and describe the types of practitioners who excise them; to examine costs; and to identify predictors of hospital admission. We used linked data for participants from the QSkin study (n = 43 794), including Medicare claims and Queensland hospital admissions relating to treatment episodes for incident keratinocyte cancers from July 2011 to June 2015. We used multinomial logistic regression to measure associations between demographic and clinical characteristics and treatment setting. The median costs of Medicare claims (AU$) were calculated. During 4 years of follow-up, there were 18 479 skin cancer excision episodes among 8613 people. Most excisions took place in private clinical rooms (89.7%), the remainder in hospitals (7.9% private; 2.4% public). Compared with other anatomical sites, skin cancers on the nose, eyelid, ear, lip, finger or genitalia were more likely to be treated in hospitals than in private clinical rooms (public hospital OR 5.7; 95%CI 4.5-7.2; private hospital OR 8.3; 95%CI 7.3-9.4). Primary care practitioners excised 83% of keratinocyte cancers, followed by plastic surgeons (9%) and dermatologists (6%). The median Medicare benefit paid was $253 in private clinical rooms and $334 in private hospitals. Out-of-pocket payments by patients treated in private hospitals were fourfold higher than those in private clinical rooms ($351 vs $80). Most keratinocyte cancers are excised in primary care, although more than 10% of excisions occur in hospital settings.
Sections du résumé
BACKGROUND/OBJECTIVE
OBJECTIVE
To describe the clinical settings in which keratinocyte cancers are excised in Queensland and describe the types of practitioners who excise them; to examine costs; and to identify predictors of hospital admission.
METHODS
METHODS
We used linked data for participants from the QSkin study (n = 43 794), including Medicare claims and Queensland hospital admissions relating to treatment episodes for incident keratinocyte cancers from July 2011 to June 2015. We used multinomial logistic regression to measure associations between demographic and clinical characteristics and treatment setting. The median costs of Medicare claims (AU$) were calculated.
RESULTS
RESULTS
During 4 years of follow-up, there were 18 479 skin cancer excision episodes among 8613 people. Most excisions took place in private clinical rooms (89.7%), the remainder in hospitals (7.9% private; 2.4% public). Compared with other anatomical sites, skin cancers on the nose, eyelid, ear, lip, finger or genitalia were more likely to be treated in hospitals than in private clinical rooms (public hospital OR 5.7; 95%CI 4.5-7.2; private hospital OR 8.3; 95%CI 7.3-9.4). Primary care practitioners excised 83% of keratinocyte cancers, followed by plastic surgeons (9%) and dermatologists (6%). The median Medicare benefit paid was $253 in private clinical rooms and $334 in private hospitals. Out-of-pocket payments by patients treated in private hospitals were fourfold higher than those in private clinical rooms ($351 vs $80).
CONCLUSIONS
CONCLUSIONS
Most keratinocyte cancers are excised in primary care, although more than 10% of excisions occur in hospital settings.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
294-300Subventions
Organisme : National Health and Medical Research Council
ID : 552429
Informations de copyright
© 2019 The Australasian College of Dermatologists.
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