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Hospital costs and health-related quality of life from complications after esophagectomy.

Authors
  • Löfgren, Anna1
  • Åkesson, Oscar2
  • Johansson, Jan2
  • Persson, Josefine3
  • 1 Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. , (Sweden)
  • 2 Department of Surgery, Skåne University Hospital, Lund, Department of Clinical Sciences. Lund University, Lund, Sweden. , (Sweden)
  • 3 Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden. Electronic address: [email protected] , (Sweden)
Type
Published Article
Journal
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Publication Date
May 01, 2021
Volume
47
Issue
5
Pages
1042–1047
Identifiers
DOI: 10.1016/j.ejso.2020.09.032
PMID: 33032864
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Approximately 50% of all patients undergoing esophagectomy experience complications. This paper estimates the costs due to complications after esophagectomy in a Swedish context. The Swedish National Register for Esophageal and Gastric Cancer (NREV) and the Healthcare Consumption Register in Region Skåne (RSVD) were crossmatched for patients undergoing esophagectomy between 2010 and 2015 in Region Skåne, Sweden (n = 132). Multivariable linear regression analysis was performed on the logarithm of total healthcare cost. HRQoL was presented descriptively. The mean total healthcare costs were 335,016 SEK (€33,502) for the group with no complications and 438,320 SEK (€43,832) and 808,461 SEK (€80,846) for minor and major complications (p < 0.001), respectively. Pneumonia (p < 0.001), laryngeal nerve paresis (p = 0.002) and other complications (p < 0.001) showed significant associations with increased healthcare cost. No significant difference was found in QALY-weights between the complication grades. Patients that underwent esophagectomy reported poorer HRQoL than the scores valued by the general background population. Complications following esophagectomy incrementally increase the healthcare costs, where more severe complications led to higher healthcare costs. The severity of complications did not affect the mean QALY-weights. Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

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