Original Clinical ScienceContribution of skin cancer to overall healthcare costs of lung transplantation in Queensland, Australia
Section snippets
Overview
Using a population-based cohort, we undertook a cost analysis to quantify the health system and patient out-of-pocket costs for lung transplant recipients following transplantation. We separately described the costs relating to the index hospitalization for transplantation (n = 45) but focus on the posttransplant total costs over 4 years (at various periods after transplant) for 90 patients. All patients had complete cost data for 4 years. The study was approved by the Human Research Ethics
Results
The mean age of participants at enrollment was 48.3 (standard deviation (SD) 12.3) years. Those with an initial diagnosis of cystic fibrosis (n = 45) were significantly younger (mean 40 vs 57 years old) than those with other lung diagnoses (Table 1). In total, 55 (61%) participants had received their transplant within 5 years of study enrollment, 20 (22%) were 6 to 10 years posttransplant, and 15 (17%) were more than 11 years posttransplant. Fifty-one (57%) participants were male, and 72 (80%)
Discussion
This study shows the healthcare costs for lung transplant recipients to governments, and patients are high for the initial transplant and ongoing care. Although lung transplant recipients are at high risk of hazardous skin cancers, a small cost proportion (0.6%) of total costs were incurred for the management of skin cancers. However, these total costs occurred over 4 years in a relatively high proportion of participants (60%), and those with skin cancers experienced 50% higher overall
Disclosure statement
This study was supported by the National Health and Medical Research Council (NHMRC) of Australia (grants 552429 and 1073898). The funder had no role in the collection of data, its analysis and interpretation, or in the right to approve or disapprove publication of the finished manuscript.
CRediT authorship contribution statement
LG performed the statistical modeling and data analysis, and produced the first written draft of the paper. LG and AG contributed to conceptualization, data analysis interpretation, writing, and editing. AG obtained the grant funding for the STAR study. PH and DC provided clinical expertise, knowledge, and intellectual inputs, obtained grants, and assisted with data collection. LG contributed to data cleaning and management. All authors were involved in writing and editing, and approved the
Acknowledgments
We sincerely thank Upekha Liyanage and Astrid Rodriguez-Acevedo for their assistance in data management and analysis during the earlier stages of this work.
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