A retrospective analysis of treatment-related hospitalization costs of pediatric, adolescent, and young adult acute lymphoblastic leukemia

Sapna Kaul, Ernest Kent Korgenski, Jian Ying, Christi F. Ng, Rochelle R. Smits-Seemann, Richard E. Nelson, Seth Andrews, Elizabeth Raetz, Mark Fluchel, Richard Lemons, Anne C. Kirchhoff

Research output: Contribution to journalArticle

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Abstract

This retrospective study examined the longitudinal hospital outcomes (costs adjusted for inflation, hospital days, and admissions) associated with the treatment of pediatric, adolescent, and young adult acute lymphoblastic leukemia (ALL). Patients between one and 26 years of age with newly diagnosed ALL, who were treated at Primary Children's Hospital (PCH) in Salt Lake City, Utah were included. Treatment and hospitalization data were retrieved from system-wide cancer registry and enterprise data warehouse. PCH is a member of the Children's Oncology Group (COG) and patients were treated on, or according to, active COG protocols. Treatment-related hospital costs of ALL were examined by computing the average annual growth rates (AAGR). Longitudinal regressions identified patient characteristics associated with costs. A total of 505 patients (46.9% female) were included. The majority of patients had B-cell lineage ALL, 6.7% had T-ALL, and the median age at diagnosis was 4 years. Per-patient, first-year ALL hospitalization costs at PCH rose from $24,197 in 1998 to $37,924 in 2012. The AAGRs were 6.1, 13.0, and 7.6% for total, pharmacy, and room and care costs, respectively. Average days (AAGR = 5.2%) and admissions (AAGR = 3.8%) also demonstrated an increasing trend. High-risk patients had 47% higher costs per 6-month period in the first 5 years from diagnosis than standard-risk patients (P < 0.001). Similarly, relapsed ALL and stem cell transplantations were associated with significantly higher costs than nonrelapsed and no transplantations, respectively (P < 0.001). Increasing treatment-related costs of ALL demonstrate an area for further investigation. Value-based interventions such as identifying low-risk fever and neutropenia patients and managing them in outpatient settings should be evaluated for reducing the hospital burden of ALL.

Original languageEnglish (US)
Pages (from-to)221-229
Number of pages9
JournalCancer Medicine
Volume5
Issue number2
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Fingerprint

Precursor Cell Lymphoblastic Leukemia-Lymphoma
Young Adult
Hospitalization
Pediatrics
Costs and Cost Analysis
Therapeutics
Hospital Costs
Growth
Economic Inflation
Stem Cell Transplantation
Cell Lineage
Neutropenia
Health Care Costs
Registries
B-Lymphocytes
Fever
Outpatients
Retrospective Studies
Transplantation

Keywords

  • Acute lymphoblastic leukemia
  • Hospital costs
  • Pediatric/adolescent/young adult

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

A retrospective analysis of treatment-related hospitalization costs of pediatric, adolescent, and young adult acute lymphoblastic leukemia. / Kaul, Sapna; Korgenski, Ernest Kent; Ying, Jian; Ng, Christi F.; Smits-Seemann, Rochelle R.; Nelson, Richard E.; Andrews, Seth; Raetz, Elizabeth; Fluchel, Mark; Lemons, Richard; Kirchhoff, Anne C.

In: Cancer Medicine, Vol. 5, No. 2, 01.02.2016, p. 221-229.

Research output: Contribution to journalArticle

Kaul, S, Korgenski, EK, Ying, J, Ng, CF, Smits-Seemann, RR, Nelson, RE, Andrews, S, Raetz, E, Fluchel, M, Lemons, R & Kirchhoff, AC 2016, 'A retrospective analysis of treatment-related hospitalization costs of pediatric, adolescent, and young adult acute lymphoblastic leukemia', Cancer Medicine, vol. 5, no. 2, pp. 221-229. https://doi.org/10.1002/cam4.583
Kaul, Sapna ; Korgenski, Ernest Kent ; Ying, Jian ; Ng, Christi F. ; Smits-Seemann, Rochelle R. ; Nelson, Richard E. ; Andrews, Seth ; Raetz, Elizabeth ; Fluchel, Mark ; Lemons, Richard ; Kirchhoff, Anne C. / A retrospective analysis of treatment-related hospitalization costs of pediatric, adolescent, and young adult acute lymphoblastic leukemia. In: Cancer Medicine. 2016 ; Vol. 5, No. 2. pp. 221-229.
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