Original Articles
Lung Cancer Diagnosis: Hospitalization Costs
José Abal Arcaa,
, Manuel Ángel Blanco Ramosb, Ramón García de la Infantac, Cristina Pérez Lópezd, Luisa González Pérezd, Joaquín Lamela Lópeza
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jaa01o@saludalia.com
Correspondence: Dr. J. Abal Arca. Servicio de Neumología. Complexo Hospitalario Ourense. Ramón Puga, 52. 32005 Ourense. España
Correspondence: Dr. J. Abal Arca. Servicio de Neumología. Complexo Hospitalario Ourense. Ramón Puga, 52. 32005 Ourense. España
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"apellidos" => "Emparanza" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906605880?idApp=UINPBA00003Z" "url" => "/15792129/0000004200000011/v1_201305150232/S1579212906605880/v1_201305150232/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Lung Cancer Diagnosis: Hospitalization Costs" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "569" "paginaFinal" => "574" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Abal Arca, Manuel Ángel Blanco Ramos, Ramón García de la Infanta, Cristina Pérez López, Luisa González Pérez, Joaquín Lamela López" "autores" => array:6 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "José Abal" "apellidos" => "Arca" "email" => array:1 [ 0 => "jaa01o@saludalia.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Manuel Ángel" "apellidos" => "Blanco Ramos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Ramón García" "apellidos" => "de la Infanta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "Cristina Pérez" "apellidos" => "López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] 4 => array:3 [ "nombre" => "Luisa González" "apellidos" => "Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] 5 => array:3 [ "nombre" => "Joaquín Lamela" "apellidos" => "López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Complexo Hospitalario Ourense, Ourense, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidad de Investigación, Complexo Hospitalario Ourense, Ourense, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Documentación Clínica, Complexo Hospitalario Ourense, Ourense, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Medicina de Familia, Complexo Hospitalario Ourense, Ourense, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J. Abal Arca. Servicio de Neumología. Complexo Hospitalario Ourense. Ramón Puga, 52. 32005 Ourense. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-06-13" "fechaAceptado" => "2006-05-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154207" "palabras" => array:3 [ 0 => "Lung cancer" 1 => "Diagnosis" 2 => "Cost" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154208" "palabras" => array:3 [ 0 => "Cáncer de pulmón" 1 => "Diagnóstico" 2 => "Coste" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To establish the direct, costs of the process of diagnosing lung cancer in 2003. As a secondary objective, the cost of admissions defined as inappropriate was evaluated.</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">A prospective cohort study of lung cancer, cases diagnosed in 2003 was performed. Diagnosis was based on cytohistology or clinical and radiological criteria. the total cost was determined according to Decree 222/2003, governing Galician health service rates. A distinction was drawn between hospitalized patients and outpatients, and between small cell and non-small cell carcinomas. Inappropriate admissions were analyzed in accordance with the criteria established by our study team, and the savings that would have been made had these patients been treated as outpatients were calculated. the statistical analyses were performed using SPSS version 10.0.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 160 patients were diagnosed with lung cancer; 76 (47.5%) of these were outpatients, and the remaining 84 (52.5%) were hospitalized patients. Admissions were considered inappropriate in 27 cases. of the total of 160 patients, 108 were diagnosed as having non-small cell carcinomas, and 38 as having small cell carcinomas; the remaining 14 patients were diagnosed on the basis of clinical-radiological criteria. Total cost was €742847 (mean. €4643; 95% confidence interval, €4049€5236), composed of €552614 (mean, €6579) for admitted patients, and €190 233 (mean, €2503) for outpatients. Mean cost was €3692 for the small cell carcinomas, and €5070 for the non-small cell carcinomas. Comparing limited and extensive small cell carcinomas, the mean cost for the former was significantly lower than for the latter (€1894 compared to €4098); there was also a lower mean cost for early compared to advanced stages of non-small cell carcinomas (€3660 compared to €5494). the savings to be made from unnecessary admissions were calculated at €120258.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The mean cost for outpatient lung cancer treatment was 62% lower than for hospitalization. Non-small cell carcinomas were more costly on average than small cell carcinomas, and advanced stages of the small cell carcinomas involved a higher average cost than the initial stages of the disease. For our series, the savings to be made from unnecessary admissions were calculated at €120258.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer los costes directos del proceso de diagnóstico del cáncer de pulmón (CP) en el año 2003. Como objetivo secundario se evaluó el coste asociado a los ingresos definidos como inadecuados.</p> <span class="elsevierStyleSectionTitle">Material y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha Ilevado a cabo un estudio de una cohorte prospectiva de casos de CP diagnosticado durante el año 2003 mediante citohistología o por criterios clinicorradiológicos. Se determinó el coste total, segün Decreto 222/2003 de Tarifas de los Servicios Sanitarios de Galicia, diferenciando entre pacientes ingresados Y ambulatorios, Y entre carcinoma microcítico Y no microcítico. Asimismo, se analizaron los ingresos inapropiados, según criterios establecidos por nuestro grupo, Y se estimó el ahorro que supondría haberlos manejado de forma ambulatoria. Para el análisis estadístico se utilizó el programa estadístico SPSS 10.0.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se diagnosticó de CP a 160 pacientes, 76 (47,5%) de forma ambulatoria Y 84 (52,5%) mediante ingreso. Éste se consideró inapropiado en 27. El diagnóstico fue de carcinoma no microcítico en 108 pacientes Y microcítico en 38, Y en 14 se estableció por criterios clinicorradiológicos. El coste total fue de 742.847 € (media: 4.643 €; intervalo de confianza del 95%, 4.0495.236), de 552.614 € (media: 6.579 €) en los ingresados Y de 190.233 € (media: 2.503 €) en los ambulatorios. El coste medio en los carcinomas microcíticos fue de 3.692 € Y en los no microcíticos de 5.070 €. En los primeros, el coste medio en la enfermedad limitada fue significativamente menor que en la enfermedad extendida (1.894 frente a 4.098 €), Y en los segundos el coste medio en los estadios iniciales también fue significativamente menor que en los avanzados (3.660 frente a 5.494 €). El ahorro estimado por ingresos inapropiados sería de 120.258 €.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El coste medio del paciente con manejo ambulatorio es un 62% inferior al que ocasiona el ingresado. El coste medio en el carcinoma no microcítico Y que en el microcítico, Y el de los estadios avanzados, mayor que el de los iniciales. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 4 | 13 |
| 2024 October | 35 | 15 | 50 |
| 2024 September | 58 | 13 | 71 |
| 2024 August | 74 | 32 | 106 |
| 2024 July | 29 | 18 | 47 |
| 2024 June | 32 | 23 | 55 |
| 2024 May | 51 | 44 | 95 |
| 2024 April | 25 | 28 | 53 |
| 2024 March | 25 | 20 | 45 |
| 2024 February | 23 | 19 | 42 |
| 2023 March | 5 | 6 | 11 |
| 2023 February | 22 | 14 | 36 |
| 2023 January | 19 | 29 | 48 |
| 2022 December | 28 | 30 | 58 |
| 2022 November | 27 | 29 | 56 |
| 2022 October | 27 | 36 | 63 |
| 2022 September | 20 | 22 | 42 |
| 2022 August | 24 | 35 | 59 |
| 2022 July | 24 | 46 | 70 |
| 2022 June | 23 | 34 | 57 |
| 2022 May | 22 | 34 | 56 |
| 2022 April | 27 | 28 | 55 |
| 2022 March | 24 | 42 | 66 |
| 2022 February | 20 | 30 | 50 |
| 2022 January | 14 | 30 | 44 |
| 2021 December | 18 | 49 | 67 |
| 2021 November | 15 | 43 | 58 |
| 2021 October | 23 | 52 | 75 |
| 2021 September | 18 | 55 | 73 |
| 2021 August | 8 | 24 | 32 |
| 2021 July | 14 | 31 | 45 |
| 2021 June | 19 | 28 | 47 |
| 2021 May | 17 | 34 | 51 |
| 2021 April | 33 | 61 | 94 |
| 2021 March | 20 | 23 | 43 |
| 2021 February | 7 | 11 | 18 |
| 2021 January | 7 | 13 | 20 |
| 2020 December | 8 | 10 | 18 |
| 2020 November | 10 | 10 | 20 |
| 2020 October | 13 | 10 | 23 |
| 2020 September | 10 | 6 | 16 |
| 2020 August | 10 | 8 | 18 |
| 2020 July | 6 | 15 | 21 |
| 2020 June | 7 | 4 | 11 |
| 2020 May | 17 | 10 | 27 |
| 2020 April | 14 | 18 | 32 |
| 2020 March | 15 | 16 | 31 |
| 2020 February | 41 | 10 | 51 |
| 2020 January | 59 | 12 | 71 |
| 2019 December | 16 | 12 | 28 |
| 2019 November | 6 | 10 | 16 |
| 2019 October | 16 | 5 | 21 |
| 2019 September | 21 | 8 | 29 |
| 2019 August | 9 | 6 | 15 |
| 2019 July | 8 | 16 | 24 |
| 2019 June | 3 | 8 | 11 |
| 2019 May | 10 | 18 | 28 |
| 2019 April | 7 | 31 | 38 |
| 2019 March | 8 | 21 | 29 |
| 2019 February | 13 | 7 | 20 |
| 2019 January | 9 | 10 | 19 |
| 2018 December | 12 | 11 | 23 |
| 2018 November | 22 | 11 | 33 |
| 2018 October | 20 | 15 | 35 |
| 2018 September | 9 | 7 | 16 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 5 | 4 | 9 |
| 2018 March | 3 | 2 | 5 |
| 2018 February | 4 | 9 | 13 |
| 2018 January | 2 | 2 | 4 |
| 2017 December | 4 | 7 | 11 |
| 2017 November | 4 | 9 | 13 |
| 2017 October | 3 | 3 | 6 |
| 2017 September | 13 | 8 | 21 |
| 2017 August | 8 | 10 | 18 |
| 2017 July | 14 | 7 | 21 |
| 2017 June | 15 | 10 | 25 |
| 2017 May | 14 | 3 | 17 |
| 2017 April | 8 | 5 | 13 |
| 2017 March | 20 | 3 | 23 |
| 2017 February | 2 | 2 | 4 |
| 2017 January | 5 | 4 | 9 |
| 2016 December | 18 | 7 | 25 |
| 2016 November | 17 | 5 | 22 |
| 2016 October | 14 | 11 | 25 |
| 2016 September | 14 | 7 | 21 |
| 2016 August | 12 | 4 | 16 |
| 2016 July | 12 | 0 | 12 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 48 | 9 | 57 |
| 2015 September | 31 | 13 | 44 |
| 2015 August | 34 | 7 | 41 |
| 2015 July | 40 | 9 | 49 |
| 2015 June | 17 | 8 | 25 |
| 2015 May | 36 | 5 | 41 |
| 2015 April | 25 | 13 | 38 |
| 2015 March | 19 | 10 | 29 |
| 2015 February | 25 | 2 | 27 |
| 2015 January | 22 | 9 | 31 |
| 2014 December | 27 | 4 | 31 |
| 2014 November | 42 | 8 | 50 |
| 2014 October | 44 | 9 | 53 |
| 2014 September | 37 | 11 | 48 |
| 2014 August | 40 | 11 | 51 |
| 2014 July | 50 | 8 | 58 |
| 2014 June | 36 | 8 | 44 |
| 2014 May | 46 | 13 | 59 |
| 2014 April | 39 | 5 | 44 |
| 2014 March | 55 | 10 | 65 |
| 2014 February | 54 | 5 | 59 |
| 2014 January | 44 | 9 | 53 |
| 2013 December | 44 | 5 | 49 |
| 2013 November | 38 | 7 | 45 |
| 2013 October | 46 | 8 | 54 |
| 2013 September | 36 | 10 | 46 |
| 2013 August | 41 | 14 | 55 |
| 2013 July | 52 | 13 | 65 |
| 2013 June | 35 | 8 | 43 |
| 2013 May | 31 | 6 | 37 |
| 2013 April | 16 | 8 | 24 |
| 2013 March | 5 | 2 | 7 |
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