A population-based analysis of attributable hospitalisation costs of invasive fungal diseases in haematological malignancy patients using data linkage of state-wide registry and costing databases: 2009-2015.
Adolescent
Adult
Aged
Aspergillosis
/ economics
Case-Control Studies
Cohort Studies
Databases, Factual
Female
Health Care Costs
Hematologic Neoplasms
/ complications
Hospitalization
/ economics
Humans
Male
Middle Aged
Mucormycosis
/ economics
Mycoses
/ complications
Registries
Retrospective Studies
Victoria
Young Adult
data linkage
health economics
hospitalisation costs
invasive fungal disease
surveillance
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
19
08
2019
revised:
23
10
2019
accepted:
26
10
2019
pubmed:
13
11
2019
medline:
1
9
2020
entrez:
13
11
2019
Statut:
ppublish
Résumé
Invasive fungal diseases (IFD) are associated with significant treatment-related costs in patients with haematological malignancies (HM). The objectives of this study were to characterise the gross and attributable hospitalisation costs of a variety of IFD in patients with HM by linking state-wide hospital administrative and costing datasets. We linked the Victorian Admitted Episodes Dataset, Victorian Cancer Registry and the Victorian Cost Data Collection from 1 July 2009 to 30 June 2015. IFD cases and uninfected controls were matched 1:1 based on age within ten years, same underlying HM and length of stay prior to IFD diagnosis. The cost difference between surviving cases and controls, indexed to 2019 Australian dollars (AUD) calculated twelve months from IFD diagnosis, was determined using Poisson and negative binomial regression (NBR). From 334 matched pairs, the gross hospitalisation cost of cases was AUD$67 277 compared to AUD$51 158 among uninfected controls, associated with an excess median hospitalisation cost of AUD$16 119 (P < .001) attributable to IFD, approximating to USD$11 362 and €10 154 at purchasing power parity. Median attributable costs were highest for patients with invasive aspergillosis (AUD$55 642; P < .001) and mucormycosis (AUD$51 272; P = .043) followed by invasive candidiasis AUD$24 572 (P < .001). No change in median excess attributable costs was observed over the study period (P = .90) Analyses by NBR revealed a 1.36-fold increase (P < .001) in total hospitalisation costs among cases as compared to controls twelve months from IFD diagnosis. Invasive aspergillosis and mucormycosis have high attributable hospitalisation costs but the overall excess IFD cost of AUD$16 119 is modest, potentially reflecting missed or miscoded fungal episodes arguing for better quality surveillance data at hospital level.
Sections du résumé
BACKGROUND
BACKGROUND
Invasive fungal diseases (IFD) are associated with significant treatment-related costs in patients with haematological malignancies (HM).
OBJECTIVES
OBJECTIVE
The objectives of this study were to characterise the gross and attributable hospitalisation costs of a variety of IFD in patients with HM by linking state-wide hospital administrative and costing datasets.
PATIENTS/METHODS
METHODS
We linked the Victorian Admitted Episodes Dataset, Victorian Cancer Registry and the Victorian Cost Data Collection from 1 July 2009 to 30 June 2015. IFD cases and uninfected controls were matched 1:1 based on age within ten years, same underlying HM and length of stay prior to IFD diagnosis. The cost difference between surviving cases and controls, indexed to 2019 Australian dollars (AUD) calculated twelve months from IFD diagnosis, was determined using Poisson and negative binomial regression (NBR).
RESULTS
RESULTS
From 334 matched pairs, the gross hospitalisation cost of cases was AUD$67 277 compared to AUD$51 158 among uninfected controls, associated with an excess median hospitalisation cost of AUD$16 119 (P < .001) attributable to IFD, approximating to USD$11 362 and €10 154 at purchasing power parity. Median attributable costs were highest for patients with invasive aspergillosis (AUD$55 642; P < .001) and mucormycosis (AUD$51 272; P = .043) followed by invasive candidiasis AUD$24 572 (P < .001). No change in median excess attributable costs was observed over the study period (P = .90) Analyses by NBR revealed a 1.36-fold increase (P < .001) in total hospitalisation costs among cases as compared to controls twelve months from IFD diagnosis.
CONCLUSION
CONCLUSIONS
Invasive aspergillosis and mucormycosis have high attributable hospitalisation costs but the overall excess IFD cost of AUD$16 119 is modest, potentially reflecting missed or miscoded fungal episodes arguing for better quality surveillance data at hospital level.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
162-171Subventions
Organisme : Medical Research Future Fund
ID : TRIP Fellowship
Organisme : Monash University
Organisme : Medical Research Future Fund TRIP
Informations de copyright
© 2019 Blackwell Verlag GmbH.
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