Direct healthcare costs of oral cancer: A retrospective study from a tertiary care center

Davide Bartolomeo Gissi; Carlota Suàrez-Fernandez; Roberto Rossi; Francesco Vitali; Alice Marzi Manfroni; Andrea Gabusi; Luca Morandi; Tiziana Balbi; Lucio Montebugnoli; Maria Pia Foschini; Achille Tarsitano

doi:10.1016/j.jcms.2024.03.002

Direct healthcare costs of oral cancer: A retrospective study from a tertiary care center

J Craniomaxillofac Surg. 2024 Mar 13:S1010-5182(24)00085-4. doi: 10.1016/j.jcms.2024.03.002. Online ahead of print.

Affiliations

¹ Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy. Electronic address: davide.gissi@unibo.it.
² Department of Surgery and Medical-Surgical Specialities, School of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain.
³ Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy.
⁴ Oral and Maxillofacial Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, Section of Maxillofacial Surgery at Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
⁵ Functional and Molecular Neuroimaging Unit, Bellaria Hospital, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
⁶ Unit of Anatomic Pathology, S. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria, Bologna, Italy.
⁷ Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology at Bellaria Hospital, University of Bologna, Bologna, Italy.

PMID: 38582671
DOI: 10.1016/j.jcms.2024.03.002

Abstract

The aim of this study was to retrospectively evaluate the direct costs of OSCC treatment and postsurgical surveillance in a tertiary hospital in northeast Italy. Sixty-three consecutive patients surgically treated for primitive OSCC at S. Orsola Hospital in Bologna (Italy) between January 2018 and January 2020 were analyzed. Billing records of the Emilia Romagna healthcare system and institutional costs were used to derive specific costs for the following clinical categories: operating theatre costs, intensive and ordinary hospitalization, radiotherapy, chemotherapy, postsurgical complications, visits, and examinations during the follow-up period. The study population comprised 17 OSCC patients classified at stage I, 14 at stage II, eight at stage III, and 24 at stage IV. The estimated mean total direct cost for OSCC treatment and postsurgical surveillance was €26 338.48 per patient (stage I: €10 733, stage II: €19 642.9, stage III: €30 361.4, stage IV: €39 957.2). An advanced diagnosis (stages III and IV), complex surgical procedure, and loco-regional recurrences resulted in variables that were significantly associated with a higher cost of OSCC treatment and postsurgical surveillance. Redirection of funds used for OSCC treatment to screening measures may be an effective strategy to improve overall health outcomes and optimize national health resources.

Keywords: Cost of illness; Healthcare costs; Mouth neoplasms; Squamous cell carcinoma.