Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Patterns of Care and Health Service Costs for Adolescent and Young Adults Cancer Survivors in Queensland (#26)

Carla Thamm 1 2 , Shafkat Jahan 3 4 , Daniel Lindsay 4 5 , Raymond J Chan 1 , Gail Garvey 3 4
  1. Caring Futures Institute , Flinders University, Adelaide, South Australia, Australia
  2. Princess Alexandra Hospital, Woolloongabba, Qld, Australia
  3. First Nations Cancer and Wellbeing Research Program, The University of Queensland, Brisbane, Queensland, Australia
  4. School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  5. QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Herston, Australia

Aims

Cancer diagnosis and treatment cause significant financial burdens on patients, families, communities, and health care funders. Direct costs to the funders for Adolescent and Young Adult (AYA) cancer survivors could be higher than adults due to unique treatment and survivorship needs. We aimed to explore the patterns of health service use and related costs for AYA cancer patients in Queensland.

Methods

This study used a Queensland population-based linked administrative dataset (CancerCostMod) containing all AYA cancer survivors (n=871; aged 15 -24) diagnosed between July 2011 and June 2015.  Records were linked to Queensland Health Admitted Patient Data, Emergency Department Information Systems (EDIS), Medicare Benefits Schedule (MBS), and Pharmaceutical Benefits Scheme (PBS) records. Health service use and associated costs over 7-years post diagnosis (from July 2011 to June 2018) were aggregated into six-month intervals from the time of diagnosis to quantify total and average cost per person for various healthcare funders.

Results  

AYA cancer survivors had a mean age of 20.3 years. The majority (90%) of these cancer survivors lived more than five years and half (49.5%) lived outside of Metropolitan areas. Public hospitals incurred higher costs ($33.7M) compared to private hospitals ($12.6M), MBS ($3.1M), EDIS ($2.3M) and PBS ($0.7M) for AYA cancer survivors. Total and average health service use and costs to different healthcare funders were highest during the first six months following a cancer diagnosis, steadily decreased over 7-60 months, and dropped significantly during 61-84 months post-diagnosis.  

Conclusions

We quantified health service use and related costs for AYA populations to inform health service delivery and models of care. The high survival rate and costs in the first six months highlight the need for targeted interventions shortly after diagnosis. Future studies should assess cost variation due to cancer characteristics and treatment modalities to guide personalised and cost-effective models of care.