Análise de custo; Câncer de boca; Câncer de orofaringe; Sistema Único de Saúde; Microcusteio; Custo da doença
Name: WILLENE MACHADO ZORZANELI
Publication date: 11/03/2024
Examining board:
Name |
Role |
|---|---|
| SANDRA LUCIA VENTORIN VON ZEIDLER | Advisor |
Summary: Cost analysis in OC/OPC is scarce, however, necessary since cost can be an essential tool for decision-making. This study aimed to estimate the direct costs of oral and oropharyngeal squamous cell carcinoma (OC/OPC) in a state in southeastern Brazil.
To this end, a cost of illness study was carried out based on the bottom-up microcosting method as a partial economic assessment, considering the direct medical costs related to outpatients and inpatients from the perspective of reimbursement rates from the Unified Health System. Data were collected from the medical records of 41 randomized patients recruited in the Interchange longitudinal study, between 2013 and 2018. All cases were confirmed as squamous cell carcinoma of the mouth and oropharynx (C02 to C06, C09 and C10 according to the International Classification of Diseases for Oncology, 3rd Edition). Each cost value was adjusted for annual accumulated inflation. The statistical analysis of descriptive analyses, parametric tests, ANOVA and Student t test and non-parametric tests, Kruskal Wallis and Mann Whitney, was used using the SPSS® Statistical program. To adjust the differences in confidence intervals at 95%, the bootstrap method was used for 5.000 resamples using the Stata® statistical program. For all statistical tests, the significance level was set at 5%. Healthcare system cost estimates for 41 patients with OC/OPC amounted to a total cost of I$164,671.07 with an average of IS$4,042.5 per patient. 22,814 procedures and uses
of health services were carried out. The sample was mostly made up of men (>80%) and aged between 51 and 60 years (41.5%). Carcinomas of the base of the tongue and floor of the mouth had the highest costs, I$4,288.25 and 6,586.88, respectively. Clinical stage III was the one with the used health services and highest costs, I$5,415.11 (p<0.001) per patient. From the perspective of the Unified Health System, there is a high-cost demand for OC/OPC treatment, especially in advanced stages of
the disease. This study contributes to decision-making regarding treatment as well as the implementation of programs aimed at early detection of diseases.
