Summary
The use of resources for breast cancer during the first five years after diagnosis by different stages of disease was evaluated on the basis of all breast cancer patients (555) diagnosed in the Tampere University hospital district (Finland). All outpatient visits or inpatient-days of these patients in any hospital of the district were recorded and the average costs of hospital-day and of outpatient visit were applied to quantify the total use of resources. During the first five years of follow-up 535 breast cancer patients had 8206 follow-up visits and spent 18472 days in hospital. The stage II–IV patients had more than twice as many outpatient visits and inpatient-days as the stage I patients. The number of hospital-days/patient-year was 2.4-fold for stage II patients and 4.1-fold for stage III–IV patients as compared to stage I patients. The overall use of resources/ patient for those with nonlocalized disease was twice as high as the use for stage I patients, while the use of resources/person-year was 2.3-fold for stage II patients and 3.6-fold for stage III–IV as compared to stage I patients. Our study in an unselected patient population during the first five years of follow-up shows that breast cancer patients diagnosed in the early stage (stage I) require far fewer health care resources than if diagnosed in advanced stages. The results can be directly transformed into costs of breast cancer control by stage of breast cancer.
References
Bailar J, Smith E: Progress against cancer. N Engl J Med 314: 1226–1232, 1986
McLelland R: Low-cost mass screening with mammography as a means of reducing overall mortality from breast cancer. Rad Clin North Am 25: 1007–1013, 1987
Tabar L, Fagerberg G, Gad Aet al.: Reduction in mortality from breast cancer after mass screening with mammography. Lancet 1: 829–832, 1985
Verbeek A, Hendriks J, Holland R, Mravunac M, Sturmans F, Day N: Reduction of breast cancer mortality through mass screening with modern mammography. Lancet 1: 1222–1224, 1984
Shapiro S, Venet W, Strax P, Venet L, Roesner R: Ten-tofourteen year effect of screening on breast cancer mortality. JNCI 69: 349–355, 1982
Moskowitz M: Costs of screening for breast cancer. Rad Clin North Am 25: 1031–1037, 1987
Hakulinen T, Pukkala E, Hakama M, Lehtonen M, Saxen E, Teppo L: Survival of cancer patients in Finland in 1953–1974. Ann Clin Res 13, suppl 31, 1981
Holli K: Organization, functions, and effectiveness of follow-up for breast cancer patients (in Finnish with English summary). Tampere: Acta Universitatis Tamperensis, Ser A, 225, 1987
Finnish Community Union. Costs of Finnish hospitals and primary health care centers in 1991 (in Finnish), 1993
Drummond M, Stoddart G, Torrance: Methods for the economic evaluation of health care programmes. Oxford: Oxford Medical Publication, 1987
Valentin J, Leitz W: Mass screening for breast cancer. Benefits, risks, costs. Med Oncol & Tumor Pharmacother 5: 77–83, 1988
Van der Maas P, de Koning H, van Ineveld Bet al.: The costeffectiveness of breast cancer screening. Int J Cancer 43: 1055–1060, 1989
De Koning H, van Ineveld M, van Oortmarssen Get al.: Breast cancer screening and cost-effectiveness; policy alternatives, quality of life considerations and the possible impact of uncertain factors. Int J Cancer 49: 531–537, 1991
Epstein R: Does the breast cancer dollar make sense? Eur J Cancer 28: 486–491, 1992
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kaija, H., Matti, H. & Tapani, H. Use of hospital services by breast cancer patients by stage of the disease: implications on the costs of cancer control. Breast Cancer Res Tr 37, 237–241 (1996). https://doi.org/10.1007/BF01806505
Issue Date:
DOI: https://doi.org/10.1007/BF01806505