A team from New Mexico, USA, investigated the natural history of esophageal adenocarcinoma, in terms of utilization of the healthcare resources and associated medical costs.
29 patients with esophageal adenocarcinoma were included in the study. All were treated at the University of New Mexico Health Center between 1992 and1998.
For each patient, all the medical resources utilized, the facility costs, and the physician fees were retrieved from computerized databases.
During the progress of the disease, the same types of diagnostic or therapeutic procedures were found to be necessary a number of times.
Patients underwent on average: 3 (range, 1-8) upper gastrointestinal endoscopies, 5 (1-11) computerized tomography scans, and 35 (5-143) X-ray examinations. The average number of radiation therapies or chemotherapies was 28 (range, 3-46), or 39 (10-74), respectively.
The large variation in the numbers of resources utilized was also reflected by a corresponding variation in total healthcare costs.
The researchers found that the mean cost per patient was $48,127, ranging between $13,454 and $139,721.
Facility costs comprised 88% of all costs, compared with physician fees, which comprised 12%.
The management of esophageal adenocarcinoma is expensive.
|Dr A Soni.|
The largest cost items were physician encounters ($16,916), radiation plus chemotherapy ($9909 plus $4891, respectively), and pharmacy prescriptions ($7565).
Dr A. Soni, of the University of New Mexico, Albuquerque, concluded on behalf of the team, "The prolonged disease process of esophageal adenocarcinoma, and the many diagnostic and therapeutic procedures, result in complications, side-effects, inconclusive tests, or failed therapies. These all markedly increase the use of healthcare resources.
"As such outcomes are the rule rather than the exception, the management of esophageal adenocarcinoma is expensive."