Health resource utilization associated with skeletal-related events: results from a retrospective European study

Eur J Health Econ. 2016 Jul;17(6):711-21. doi: 10.1007/s10198-015-0716-7. Epub 2015 Aug 8.

Abstract

Background: Bone complications, also known as skeletal-related events (SREs), are common in patients with bone metastases secondary to advanced cancers.

Objective: To provide a detailed estimate of the health resource utilization (HRU) burden associated with SREs across eight European countries.

Methods: Eligible patients from centers in Austria, the Czech Republic, Finland, Greece, Poland, Portugal, Sweden, and Switzerland with bone metastases or lesions secondary to breast cancer, prostate, or lung cancer or multiple myeloma who had experienced at least one SRE (defined as radiation to bone, long-bone pathologic fracture, other bone pathologic fracture, surgery to bone or spinal cord compression) were entered into this study. HRU data were extracted retrospectively from the patients' charts from 3.5 months before the index SRE until 3 months after the index SRE (defined as an SRE preceded by an SRE-free period of at least 6.5 months).

Results: Overall, the mean number of inpatient stays per SRE increased from baseline by approximately 0.5-1.5 stays, with increases in the total duration of inpatient stays of approximately 6-37 days per event. All SREs were associated with substantial increases from baseline in the frequency of procedures and the number of outpatient and day-care visits.

Conclusions: SREs are associated with substantial HRU owing to considerable increases in the number and duration of inpatient stays, and in the number of procedures, outpatient visits, and day-care visits. These data collectively provide a valuable summary of the real-world SRE burden on European healthcare systems.

Keywords: Bone metastases; Breast cancer; Health resource utilization (HRU); Lung cancer; Prostate cancer; Skeletal-related event (SRE).

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Neoplasms / epidemiology*
  • Bone Neoplasms / radiotherapy
  • Bone Neoplasms / secondary*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / pathology
  • Europe / epidemiology
  • Female
  • Fractures, Bone / pathology
  • Hospitalization / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Lung Neoplasms
  • Male
  • Middle Aged
  • Multiple Myeloma
  • Neoplasm Metastasis
  • Primary Health Care / statistics & numerical data*
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / pathology
  • Retrospective Studies
  • Spinal Cord Compression / pathology