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Estimation of hospital costs for colorectal cancer care in Nova Scotia.

BACKGROUND
Colorectal cancer (CRC) is the second most common invasive cancer in Canada. Estimates of the costs of care allow estimation of the cost effectiveness of screening for premalignant and early disease.


OBJECTIVE
To estimate, from administrative data, the hospital costs incurred by a population-based cohort of CRC cases over three years from diagnosis.


DESIGN
All Nova Scotia residents with CRC who were diagnosed in 1990 were identified from the Nova Scotia Cancer Registry. These cases were linked to the administrative files of the Nova Scotia Department of Health, which contain information on diagnosis, procedures and length of stay for all admissions and day surgery visits to Nova Scotia hospitals.


MEASUREMENTS
The lengths of stay and hospital-specific per diem rates were used as the measures of resource use. The costs were analyzed in terms of the extent of spread at diagnosis; the time period after diagnosis; the time period before death; and, for typical cases, the age and presence of comorbidity identified during the initial surgical admission.


RESULTS
The estimated three-year hospital cost for the complete cohort of 593 cases was $9.8 million. This cost was significantly less for cases with local spread, highest in the six months around, and after diagnosis and in the final six months of life, and highest in the typical cases (patients who were older and had significant comorbid conditions).


CONCLUSIONS
Hospital-specific per diem rates and lengths of stay are an approximate measure of hospital resource use.