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Article ; Online: Healthcare costs of cancer among children, adolescents, and young adults: A scoping review.

Nabukalu, Doreen / Gordon, Louisa G / Lowe, John / Merollini, Katharina M D

2024 Volume 13, Issue 3, Page(s) e6925

Abstract: Objective: To collate and critically review international evidence on the direct health system costs of children and adolescents and young adults (AYA) with cancer.: Methods: We conducted searches in PubMed, MEDLINE, CINAHL, and Scopus. Articles were ...

Abstract	Objective: To collate and critically review international evidence on the direct health system costs of children and adolescents and young adults (AYA) with cancer. Methods: We conducted searches in PubMed, MEDLINE, CINAHL, and Scopus. Articles were limited to studies involving people aged 0-39 years at cancer diagnosis and published from 2012 to 2022. Two reviewers screened the articles and evaluated the studies using the Consolidated Health Economic Evaluation Reporting Standards checklist. The reviewers synthesized the findings using a narrative approach and presented the costs in 2022 US dollars for comparability. Results: Overall, the mean healthcare costs for all cancers in the 5 years post diagnosis ranged from US$36,670 among children in Korea to US$127,946 among AYA in the USA. During the first year, the mean costs among children 0-14 years ranged from US$34,953 in Chile to over US$130,000 in Canada. These were higher than the costs for AYA, estimated at US$61,855 in Canada. At the end of life, the mean costs were estimated at over US$300,000 among children and US$235,265 among adolescents in Canada. Leukemia was the most expensive cancer type, estimated at US$50,133 in Chile, to US$152,533 among children in Canada. Overall, more than a third of the total cost is related to hospitalizations. All the included studies were of good quality. Conclusions: Healthcare costs associated with cancer are substantial among children, and AYA. More research is needed on the cost of cancer in low- and middle-income countries and harmonization of costs across countries.
MeSH term(s)	Child ; Adolescent ; Humans ; Young Adult ; Neoplasms/epidemiology ; Neoplasms/therapy ; Health Care Costs ; Leukemia ; Canada ; Checklist
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.6925
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Article ; Online: Frequency of colorectal surveillance colonoscopies for adenomatous polyps: systematic review and meta-analysis.

Ho, Yiu Ming / Merollini, Katharina M D / Gordon, Louisa G

Journal of gastroenterology and hepatology

2023 Volume 39, Issue 1, Page(s) 37–46

Abstract: Background and aim: The purpose of this study was to assess evidence on the frequency of polyp surveillance colonoscopies performed earlier than the recommended follow-up intervals in clinical practice guidelines.: Methods: A systematic review was ... ...

Abstract	Background and aim: The purpose of this study was to assess evidence on the frequency of polyp surveillance colonoscopies performed earlier than the recommended follow-up intervals in clinical practice guidelines. Methods: A systematic review was performed based on electronic searches in PubMed and Embase. Research articles, letters to the editors, and review articles, published before April 2022, were included. Studies that focused on the intervals of polyp surveillance in adult populations were selected. The Risk Of Bias In Non-randomized Studies of Exposure (ROBINS-E) was used to assess the risk of bias. A meta-analysis was performed with Forest plots to illustrate the results. Results: In total, 16 studies, comprising 11 172 patients from Australia, Europe, and North America, were included for analysis. The quality of the studies was moderate. Overall, 38% (95% CI: 30-47%) of colonoscopies were undertaken earlier than their respective national clinical guidelines. In risk-stratified surveillance, 10 studies contained data relating to low-risk polyp surveillance intervals and 30% (95% CI: 29-31%) of colonoscopies were performed earlier than recommended. Eight studies contained data relating to intermediate-risk polyp surveillance and 15% (95% CI: 14-17%) of colonoscopies were performed earlier than recommended. One study showed that 6% (95% CI: 4-10%) of colonoscopies performed for high-risk polyp surveillance were performed earlier than recommended. Conclusions: A significant proportion of polyp surveillance was performed earlier than the guidelines suggested. This provides evidence of the potential overuse of healthcare resources and the opportunity to improve hospital efficiency.
MeSH term(s)	Humans ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Adenomatous Polyps/diagnosis ; Adenomatous Polyps/epidemiology ; Colonoscopy/methods ; Polyps ; North America/epidemiology ; Colonic Polyps/diagnosis ; Colonic Polyps/epidemiology
Language	English
Publishing date	2023-11-15
Publishing country	Australia
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	632882-9
ISSN	1440-1746 ; 0815-9319
ISSN (online)	1440-1746
ISSN	0815-9319
DOI	10.1111/jgh.16397
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Zs.A 2180: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Induction of labor using balloon catheter as an outpatient versus prostaglandin as an inpatient: A cost-effectiveness analysis.

Merollini, Katharina M D / Beckmann, Michael

European journal of obstetrics, gynecology, and reproductive biology

2021 Volume 260, Page(s) 124–130

Abstract: Objective: The aim of this work was to assess the cost-effectiveness of induction of labor with outpatient balloon catheter cervical priming versus inpatient prostaglandin vaginal gel or tape.: Study design: Economic evaluation alongside a multi- ... ...

Abstract	Objective: The aim of this work was to assess the cost-effectiveness of induction of labor with outpatient balloon catheter cervical priming versus inpatient prostaglandin vaginal gel or tape. Study design: Economic evaluation alongside a multi-centre, randomized controlled trial at eight Australian maternity hospitals. The trial reported on 448 women with live singleton term pregnancies, undergoing induction of labor for low-risk indications between September 2015 and October 2018. An economic decision tree model was designed from a health services perspective from time of induction of labor to hospital discharge. Sensitivity and subgroup analyses were performed to test the robustness of model outcomes. We estimated resource use, collected data on health outcomes (using EQ-5D-3 L questionnaire) and reported cost (Australian Dollars) per quality-adjusted life year gained, incremental cost-effect ratio and net monetary benefit. Results: Deterministic analysis showed lower mean costs ($7294 versus $7585) in the outpatient-balloon (n = 205) compared to the inpatient-prostaglandin group (n = 243), with similar health outcomes (0.75 vs 0.74 quality-adjusted life years gained) and overall higher net monetary benefit ($30,054 vs $29,338). In probabilistic analyses outpatient-balloon induction of labor was cost-effective in 55.3 % of all simulations and 59.1 % for women with favourable cervix (modified Bishop score >3) and 64.5 % for nulliparous women. Conclusions: Outpatient-balloon induction of labor may be cost-saving compared to inpatient induction of labor with prostaglandin and is most likely to be cost-effective for nulliparous women, but more research is warranted in other settings to explore the generalisability of results.
MeSH term(s)	Australia ; Cervical Ripening ; Cost-Benefit Analysis ; Female ; Humans ; Labor, Induced ; Outpatients ; Oxytocics ; Pregnancy ; Prostaglandins
Chemical Substances	Oxytocics ; Prostaglandins
Language	English
Publishing date	2021-03-15
Publishing country	Ireland
Document type	Journal Article ; Multicenter Study
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2021.03.020
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Article ; Online: Cancer Survivors' Long-Term Health Service Costs in Queensland, Australia: Results of a Population-Level Data Linkage Study (Cos-Q).

Merollini, Katharina M D / Gordon, Louisa G / Ho, Yiu M / Aitken, Joanne F / Kimlin, Michael G

International journal of environmental research and public health

2022 Volume 19, Issue 15

Abstract: Worldwide, the number of cancer survivors is rapidly increasing. The aim of this study was to quantify long-term health service costs of cancer survivorship on a population level. The study cohort comprised residents of Queensland, Australia, diagnosed ... ...

Abstract	Worldwide, the number of cancer survivors is rapidly increasing. The aim of this study was to quantify long-term health service costs of cancer survivorship on a population level. The study cohort comprised residents of Queensland, Australia, diagnosed with a first primary malignancy between 1997 and 2015. Administrative databases were linked with cancer registry records to capture all health service utilization. Health service costs between 2013-2016 were analyzed using a bottom-up costing approach. The cumulative mean annual healthcare expenditure (2013-2016) for the cohort of N = 230,380 individuals was AU$3.66 billion. The highest costs were incurred by patients with a history of prostate (AU$538 m), breast (AU$496 m) or colorectal (AU$476 m) cancers. Costs by time since diagnosis were typically highest in the first year after diagnosis and decreased over time. Overall mean annual healthcare costs per person (2013-2016) were AU$15,889 (SD: AU$25,065) and highest costs per individual were for myeloma (AU$45,951), brain (AU$30,264) or liver cancer (AU$29,619) patients. Our results inform policy makers in Australia of the long-term health service costs of cancer survivors, provide data for economic evaluations and reinforce the benefits of investing in cancer prevention.
MeSH term(s)	Australia/epidemiology ; Cancer Survivors ; Health Care Costs ; Health Services ; Humans ; Information Storage and Retrieval ; Male ; Neoplasms/epidemiology ; Neoplasms/therapy ; Queensland/epidemiology
Language	English
Publishing date	2022-08-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19159473
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Article ; Online: Presenteeism among health care workers with laboratory-confirmed influenza infection: A retrospective cohort study in Queensland, Australia.

Imai, Chisato / Hall, Lisa / Lambert, Stephen B / Merollini, Katharina M D

American journal of infection control

2019 Volume 48, Issue 4, Page(s) 355–360

Abstract: Background: A high prevalence of working while ill (presenteeism) has been documented among health care workers (HCWs). However, previous evidence is primarily based on nonspecific causes of sickness and self-reported data. Our study examined ... ...

Abstract	Background: A high prevalence of working while ill (presenteeism) has been documented among health care workers (HCWs). However, previous evidence is primarily based on nonspecific causes of sickness and self-reported data. Our study examined presenteeism among HCWs with laboratory-confirmed influenza. Methods: The data pertaining to laboratory-confirmed influenza cases and history of sick leave among HCWs in Queensland, Australia, were collected from 2009-2015. The incidence and duration of sick leave around the time of disease confirmation were analyzed. The associations of factors, such as job category and employment status, on presenteeism were assessed with regression analyses. Results: The overall sick leave incidence was 85.9% in the laboratory-confirmed periods, which translates that 14.1% of HCWs were working while ill with influenza. Among medical doctors, approximately one-quarter of them were attending work in the period. A shorter duration of leave was also observed among medical doctors and full-time employees compared with other HCWs and part-time employees. Conclusions: Presenteeism among HCWs with influenza put both HCWs and patients at risk by increasing potential for transmission. Our findings emphasize the importance of an integrated approach including both HCW sick leave management and vaccination for strategic prevention and control of nosocomial influenza infection.
MeSH term(s)	Cohort Studies ; Cross Infection/prevention & control ; Health Personnel ; Hospitals ; Humans ; Influenza, Human ; Presenteeism ; Queensland ; Retrospective Studies
Language	English
Publishing date	2019-09-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2019.07.024
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Zs.A 1773: Show issues

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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
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Article ; Online: Lifetime Costs of Surviving Cancer-A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study.

Merollini, Katharina M D / Gordon, Louisa G / Aitken, Joanne F / Kimlin, Michael G

International journal of environmental research and public health

2020 Volume 17, Issue 8

Abstract: Australia-wide, there are currently more than one million cancer survivors. There are over 32 million world-wide. A trend of increasing cancer incidence, medical innovations and extended survival places growing pressure on healthcare systems to manage ... ...

Abstract	Australia-wide, there are currently more than one million cancer survivors. There are over 32 million world-wide. A trend of increasing cancer incidence, medical innovations and extended survival places growing pressure on healthcare systems to manage the ongoing and late effects of cancer treatment. There are no published studies of the long-term health service use and cost of cancer survivorship on a population basis in Australia. All residents of the state of Queensland, Australia, diagnosed with a first primary malignancy from 1997-2015 formed the cohort of interest. State and national healthcare databases are linked with cancer registry records to capture all health service utilization and healthcare costs for 20 years (or death, if this occurs first), starting from the date of cancer diagnosis, including hospital admissions, emergency presentations, healthcare costing data, Medicare services and pharmaceuticals. Data analyses include regression and economic modeling. We capture the whole journey of health service contact and estimate long-term costs of all cancer patients diagnosed and treated in Queensland by linking routinely collected state and national healthcare data. Our results may improve the understanding of lifetime health effects faced by cancer survivors and estimate related healthcare costs. Research outcomes may inform policy and facilitate future planning for the allocation of healthcare resources according to the burden of disease.
MeSH term(s)	Cancer Survivors ; Health Care Costs ; Humans ; Information Storage and Retrieval ; National Health Programs ; Neoplasms/economics ; Queensland/epidemiology ; Research Design
Language	English
Publishing date	2020-04-20
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17082831
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Article ; Online: Women's experience of induction of labor using PGE2 as an inpatient versus balloon catheter as an outpatient.

Beckmann, Michael / Acreman, Melissa / Schmidt, Emily / Merollini, Katharina M D / Miller, Yvette

European journal of obstetrics, gynecology, and reproductive biology

2020 Volume 249, Page(s) 1–6

Abstract: Objective: Induction of labor (IOL) typically involves cervical priming in an inpatient setting. Outpatient cervical priming may be a safe and cost-effective alternative. However, little is known about women's preference and the impact of outpatient ... ...

Abstract	Objective: Induction of labor (IOL) typically involves cervical priming in an inpatient setting. Outpatient cervical priming may be a safe and cost-effective alternative. However, little is known about women's preference and the impact of outpatient cervical priming on their healthcare experience. The objective was to compare women's healthcare experiences following IOL using a balloon catheter and going home, versus prostaglandin (PG) and remaining an inpatient. Study design: A randomized controlled trial was undertaken across eight Australian maternity hospitals. Between September 2015 and October 2018, 695 women with uncomplicated term singleton pregnancies were randomized. Of these, 215 and 233 women in the balloon-outpatient and PG-inpatient groups, respectively, received the allocated intervention. The PG group received Dinoprostone gel or controlled-release tape. The balloon group had a double-balloon catheter inserted and went home. Experiential and quality-of-life outcomes were measured via written questionnaire after birth. The primary outcome was a composite neonatal measure. Women's healthcare experience, health-state (EQ-5D-3 L) and pain scores are reported here. Results: Questionnaire data were available for 366 (81.7 %) women enrolled who received their treatment allocation. More women in the balloon-outpatient group reported they would choose IOL next pregnancy (49.2 % vs 38.4 %; p = 0.037) and desire the same method (72.4 % vs 61.1 %; p = 0.022). The balloon-outpatient group experienced higher pain scores at the start of IOL (median (IQR) 3(2-5) vs 2(1-4); p = 0.002) but lower scores at time of rupture of membranes (3(1-5) vs 4(2-6); p = 0.007). The EQ-5D-3 L health-utility index did not differ significantly between the groups (0.77 vs 0.78; p = 0.899). Conclusions: Women report similar healthcare experiences following balloon-outpatient compared to PG-impatient IOL, but are more likely to desire the same method next pregnancy if IOL is required. If both options are available, then differences in experience should be shared with women, alongside differences in clinical outcomes as part of their decision-making process.
MeSH term(s)	Adult ; Ambulatory Care/methods ; Ambulatory Care/psychology ; Australia ; Catheterization/methods ; Dinoprostone/administration & dosage ; Female ; Hospitals, Maternity ; Humans ; Inpatients/psychology ; Labor, Induced/methods ; Labor, Induced/psychology ; Outpatients/psychology ; Oxytocics/administration & dosage ; Patient Preference ; Patient Reported Outcome Measures ; Pregnancy
Chemical Substances	Oxytocics ; Dinoprostone (K7Q1JQR04M)
Language	English
Publishing date	2020-04-04
Publishing country	Ireland
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2020.03.031
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Article ; Online: Estimated Healthcare Costs of Melanoma and Keratinocyte Skin Cancers in Australia and Aotearoa New Zealand in 2021.

Gordon, Louisa G / Leung, William / Johns, Richard / McNoe, Bronwen / Lindsay, Daniel / Merollini, Katharina M D / Elliott, Thomas M / Neale, Rachel E / Olsen, Catherine M / Pandeya, Nirmala / Whiteman, David C

International journal of environmental research and public health

2022 Volume 19, Issue 6

Abstract: Australia and Aotearoa New Zealand have the highest incidence of melanoma and KC in the world. We undertook a cost-of-illness analysis using Markov decision-analytic models separately for melanoma and keratinocyte skin cancer (KC) for each country. Using ...

Abstract	Australia and Aotearoa New Zealand have the highest incidence of melanoma and KC in the world. We undertook a cost-of-illness analysis using Markov decision-analytic models separately for melanoma and keratinocyte skin cancer (KC) for each country. Using clinical pathways, the probabilities and unit costs of each health service and medicine for skin cancer management were applied. We estimated mean costs and 95% uncertainty intervals (95% UI) using Monte Carlo simulation. In Australia, the mean first-year costs of melanoma per patient ranged from AU$644 (95%UI: $642, $647) for melanoma
MeSH term(s)	Australia/epidemiology ; Cost-Benefit Analysis ; Health Care Costs ; Humans ; Keratinocytes ; Melanoma/epidemiology ; Melanoma/prevention & control ; New Zealand/epidemiology ; Skin Neoplasms/epidemiology ; Skin Neoplasms/prevention & control ; Melanoma, Cutaneous Malignant
Language	English
Publishing date	2022-03-08
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19063178
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Article ; Online: A Systematic Review of Financial Toxicity Among Cancer Survivors: We Can't Pay the Co-Pay.

Gordon, Louisa G / Merollini, Katharina M D / Lowe, Anthony / Chan, Raymond J

The patient

2016 Volume 10, Issue 3, Page(s) 295–309

Abstract: Objective: To determine the extent of financial toxicity (FT) among cancer survivors, identify the determinants and how FT is measured.: Methods: A systematic review was performed in MEDLINE, CINAHL and PsycINFO, using relevant terminology and ... ...

Abstract	Objective: To determine the extent of financial toxicity (FT) among cancer survivors, identify the determinants and how FT is measured. Methods: A systematic review was performed in MEDLINE, CINAHL and PsycINFO, using relevant terminology and included articles published from 1 January, 2013 to 30 June, 2016. We included observational studies where the primary outcomes included FT and study samples were greater than 200. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Results: From 417 citations, a total of 25 studies were included in this review. Seventy outcomes of FT were reported with 47 covering monetary, objective and subjective indicators of FT. A total of 28-48% of patients reported FT using monetary measures and 16-73% using subjective measures. The most commonly reported factors associated with FT were: being female, younger age, low income at baseline, adjuvant therapies and more recent diagnosis. Relative to non-cancer comparison groups, cancer survivors experienced significantly higher FT. Most studies were cross-sectional and causal inferences between FT and determinants were not possible. Measures of FT were varied and most were not validated, while monetary values of out-of-pocket expenses included different cost components across studies. Conclusions: A substantial proportion of cancer survivors experience financial hardship irrespective of how it is measured. Using standardised outcomes and longitudinal designs to measure FT would improve determination of the extent of FT. Further research is recommended on reduced work participation and income losses occurring concurrently with FT and on the impacts on treatment non-adherence.
MeSH term(s)	Cancer Survivors/statistics & numerical data ; Cost Sharing/economics ; Cross-Sectional Studies ; Financing, Personal/economics ; Health Expenditures/statistics & numerical data ; Humans
Language	English
Publishing date	2016-10-18
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2466680-4
ISSN	1178-1661 ; 1178-1653
ISSN (online)	1178-1661
ISSN	1178-1653
DOI	10.1007/s40271-016-0204-x
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Article ; Online: Surgical treatment approaches and reimbursement costs of surgical site infections post hip arthroplasty in Australia: a retrospective analysis.

Merollini, Katharina M D / Crawford, Ross W / Graves, Nicholas

BMC health services research

2013 Volume 13, Page(s) 91

Abstract: Background: The treatment for deep surgical site infection (SSI) following primary total hip arthroplasty (THA) varies internationally and it is at present unclear which treatment approaches are used in Australia. The aim of this study is to identify ... ...

Abstract	Background: The treatment for deep surgical site infection (SSI) following primary total hip arthroplasty (THA) varies internationally and it is at present unclear which treatment approaches are used in Australia. The aim of this study is to identify current treatment approaches in Queensland, Australia, show success rates and quantify the costs of different treatments. Methods: Data for patients undergoing primary THA and treatment for infection between January 2006 and December 2009 in Queensland hospitals were extracted from routinely used hospital databases. Records were linked with pathology information to confirm positive organisms. Diagnosis and treatment of infection was determined using ICD-10-AM and ACHI codes, respectively. Treatment costs were estimated based on AR-DRG cost accounting codes assigned to each patient hospital episode. Results: A total of n=114 patients with deep surgical site infection were identified. The majority of patients (74%) were first treated with debridement, antibiotics and implant retention (DAIR), which was successful in eradicating the infection in 60.3% of patients with an average cost of $13,187. The remaining first treatments were 1-stage revision, successful in 89.7% with average costs of $27,006, and 2-stage revisions, successful in 92.9% of cases with average costs of $42,772. Multiple treatments following 'failed DAIR' cost on average $29,560, for failed 1-stage revision were $24,357, for failed 2-stage revision were $70,381 and were $23,805 for excision arthroplasty. Conclusions: As treatment costs in Australia are high primary prevention is important and the economics of competing treatment choices should be carefully considered. These currently vary greatly across international settings.
MeSH term(s)	Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip/adverse effects ; Australia/epidemiology ; Female ; Health Care Costs ; Humans ; Insurance, Health, Reimbursement/economics ; Male ; Middle Aged ; Postoperative Complications/economics ; Queensland ; Retrospective Studies ; Surgical Wound Infection/economics ; Surgical Wound Infection/epidemiology
Language	English
Publishing date	2013-03-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1472-6963
ISSN (online)	1472-6963
DOI	10.1186/1472-6963-13-91
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