Factors affecting hospital costs in lung cancer patients in the United Kingdom

• Most costs (58.5%) accumulated in the first 90 days.
• Acute inpatient costs (42.1%) were the largest contributor.
• Strongest predictor of costs was active treatment.
• Increasing radical treatment rates may significantly increase costs.
• Routine NHS data can enable analyses of large cohort health economic data.

IntroductionRising healthcare costs and financial constraints are increasing pressure on healthcare budgets. There is little published data on the healthcare costs of lung cancer in the UK, with international studies mostly small and limited by data collection methods. Accurate assessment of healthcare costs is essential for effective service planning.MethodsWe conducted a retrospective, descriptive cohort study linking clinical data from a local electronic database of lung cancer patients at a large UK teaching hospital with recorded hospital income. Costs were adjusted to 2013–2014 prices.ResultsThe study analysed secondary care costs of 3274 patients. Mean cumulative costs were £5852 (95% CI, £5694 to £6027) at 90 days and £10,009 (95% CI, £9717 to £10,278) at one year. The majority of costs (58.5%) were accumulated within the first 90 days, with acute inpatient costs the largest contributor at one year (42.1%). The strongest predictor of costs was active treatment, especially surgery. Costs were also affected by age, route to diagnosis, clinical stage and cell type.DiscussionSuccessful early diagnosis initiatives that increase radical treatment rates and improve outcomes may significantly increase the secondary care costs of lung cancer management. The use of routine NHS clinical and financial data can enable efficient and effective analyses of large cohort health economic data.