Publication details

Analýza nákladů na radioterapii v lůžkové péči – hledání vhodných prediktorů pro potřeby nového prospektivního úhradového modelu

Title in English Cost Analysis of Radiotherapy Provided in Inpatient Setting – Testing Potential Predictors for a New Prospective Payment System
Authors

ŠEDO Jiří BLAHA Milan PAVLÍK Tomáš KLIKA Petr DUŠEK Ladislav BÜCHLER T. ABRAHÁMOVÁ J. ŠRÁMEK V. ŠLAMPA P. KOMÍNEK Libor POSPÍŠIL Petr SLÁMA Ondřej VYZULA Rostislav

Year of publication 2014
Type Article in Periodical
Magazine / Source Klinická onkologie
MU Faculty or unit

Faculty of Medicine

Citation
Field Applied statistics, operation research
Keywords health care costs; radiotherapy; radiation oncology; prospective payment system; reimbursement mechanisms; diagnosis-related groups
Description As a part of the development of a new prospective payment model for radiotherapy we analyzed data on costs of care provided by three comprehensive cancer centers in the Czech Republic. Our aim was to fi nd a combination of variables (predictors) which could be used to sort hospitalization cases into groups according to their costs, with each group having the same reimbursement rate. We tested four variables as possible predictors – number of fractions, stage of disease, radiotherapy technique and dia gnostic group. Methods: We analyzed 7,440 hospitalization cases treated in three comprehensive cancer centers from 2007 to 2011. We acquired data from the I- COP database developed by Institute of Biostatistics and Analyses of Masaryk University in cooperation with oncology centers that contains records from the National Oncological Registry along with data supplied by healthcare providers to insurance companies for the purpose of retrospective reimbursement. Results: When comparing the four variables mentioned above we found that number of fractions and radiotherapy technique were much stronger predictors than the other two variables. Stage of disease did not prove to be a relevant indicator of cost distinction. There were signifi cant diff erences in costs among dia gnostic groups but these were mostly driven by the technique of radiotherapy and the number of fractions. Within the dia gnostic groups, the distribution of costs was too heterogeneous for the purpose of the new payment model. Conclusion: The combination of number of fractions and radiotherapy technique appears to be the most appropriate cost predictors to be involved in the prospective payment model proposal. Further analysis is planned to test the predictive value of intention of radiotherapy in order to determine diff erences in costs between palliative and curative treatment.
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