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Comparing childhood cancer care costs in two Canadian provinces

McBride ML, de Oliveira C, Duncan R, Bremner KE, Liu N, Greenberg ML, Nathan PC, Rogers PC, Peacock SJ, Krahn MD. Healthc Policy. 2020; 15(3):76-88. Epub 2020 Feb 1. DOI: https://doi.org/10.12927/hcpol.2020.26129


Background — Cancer in children presents unique issues for diagnosis, treatment and survivorship care. Phase-specific comparative cost estimates are important for informing healthcare planning.

Objectives — The aim of this paper is to compare direct medical costs of childhood cancer by phase of care in British Columbia (BC) and Ontario (ON).

Methods — For cancer patients diagnosed at <15 years of age and propensity-score-matched non-cancer controls, we applied standard costing methodology using population-based healthcare administrative data to estimate and compare phase-based costs by province.

Results — Phase-specific cancer-attributable costs were 2%–39% higher for ON than for BC. Leukemia pre-diagnosis costs and annual lymphoma continuing care costs were >50% higher in ON. Phase-specific in-patient hospital costs (the major cost category) represented 63%–82% of ON costs, versus 43%–73% of BC costs. Phase-specific diagnostic tests and procedures accounted for 1.0%–3.4% of ON costs and 2.8%–13.0% of BC costs.

Conclusions — There are substantial cost differences between these two Canadian provinces, BC and ON, possibly identifying opportunities for healthcare planning improvement.

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