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Volume 19
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Article

Population-Based Home Care Services in Breast Cancer: Utilization and Costs

by
N. Mittmann
1,2,3,*,
P.K. Isogai
1,
R. Saskin
4,
N. Liu
4,
J.M. Porter
4,
M.C. Cheung
5,6,
N.B. Leighl
6,7,
J.S. Hoch
8,9,10,11,
M.E. Trudeau
5,6,
W.K. Evans
12,
K.N. Dainty
11 and
C.C. Earle
4,5,6
1
Health Outcomes and Pharmaco Economic (HOPE) Research Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
2
Department of Pharmacology, University of Toronto, Toronto, ON, Canada
3
International Centre for Health Innovation (ICHI), Richard Ivey School of Business, Western University, London, ON, Canada
4
Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada
5
Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
6
Department of Medicine, University of Toronto, Toronto, ON, Canada
7
Princess Margaret Hospital, Toronto, ON, Canada
8
Canadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada
9
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
10
Pharmacoeconomics Research Unit, Cancer Care Ontario, Toronto, ON, Canada
11
Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
12
Department of Oncology, McMaster University, Hamilton, ON, Canada
 
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*
Author to whom correspondence should be addressed.
Curr. Oncol. 2012, 19(6), 383-391; https://doi.org/10.3747/co.19.1078
Submission received: 4 September 2012 / Revised: 8 October 2012 / Accepted: 7 November 2012 / Published: 1 December 2012

Abstract

Objective: To determine utilization and costs of home care services (HCS) for individuals with a diagnosis of breast cancer (BC). Methods: Incident cases of invasive BC in women were extracted from the Ontario Cancer Registry (2005–2009) and linked with other Ontario health care administrative databases. Control patients were selected from the population of women never diagnosed with any type of cancer. The types and proportions of HCS used were determined and stratified by disease stage. Attributable home care utilization and costs for BC patients were determined. Factors associated with HCS costs were assessed using regression analysis. Results: Among the 39,656 BC and 198,280 control patients identified (median age: 61.6 years for both), 75.4% of BC patients used HCS (62.1% stage I; 85.7% stage II; 94.6% stage III; 79.1% stage IV) compared with 14.6% of control patients. The number of HCS used per patient–year were significantly higher for the BC patients than for the control patients (14.97 vs. 6.13, p < 0.01), resulting in higher costs per patient–year ($1,210 vs. $325; $885 attributable cost to BC, p < 0.01). The number of HCS utilized and the associated costs increased as the BC stage increased. In contrast, HCS costs decreased as income increased and as previous health care exposure decreased. Interpretation: Patients with BC used twice as many HCS, resulting in costs that were almost 4 times those observed in a matched control group. Less than an additional $1000 per BC patient per year were spent on HCS utilization in the study population.
Keywords: breast cancer; home care; costs; population-based; disease stage breast cancer; home care; costs; population-based; disease stage

Share and Cite

MDPI and ACS Style

Mittmann, N.; Isogai, P.K.; Saskin, R.; Liu, N.; Porter, J.M.; Cheung, M.C.; Leighl, N.B.; Hoch, J.S.; Trudeau, M.E.; Evans, W.K.; et al. Population-Based Home Care Services in Breast Cancer: Utilization and Costs. Curr. Oncol. 2012, 19, 383-391. https://doi.org/10.3747/co.19.1078

AMA Style

Mittmann N, Isogai PK, Saskin R, Liu N, Porter JM, Cheung MC, Leighl NB, Hoch JS, Trudeau ME, Evans WK, et al. Population-Based Home Care Services in Breast Cancer: Utilization and Costs. Current Oncology. 2012; 19(6):383-391. https://doi.org/10.3747/co.19.1078

Chicago/Turabian Style

Mittmann, N., P.K. Isogai, R. Saskin, N. Liu, J.M. Porter, M.C. Cheung, N.B. Leighl, J.S. Hoch, M.E. Trudeau, W.K. Evans, and et al. 2012. "Population-Based Home Care Services in Breast Cancer: Utilization and Costs" Current Oncology 19, no. 6: 383-391. https://doi.org/10.3747/co.19.1078

APA Style

Mittmann, N., Isogai, P. K., Saskin, R., Liu, N., Porter, J. M., Cheung, M. C., Leighl, N. B., Hoch, J. S., Trudeau, M. E., Evans, W. K., Dainty, K. N., & Earle, C. C. (2012). Population-Based Home Care Services in Breast Cancer: Utilization and Costs. Current Oncology, 19(6), 383-391. https://doi.org/10.3747/co.19.1078

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