12th May 2017, Volume 130 Number 1455

Rahul Jayakar, Jenny Choi, Craig MacKinnon, Swee Tan

Head and neck cancer (HNC) includes cancer arising from the upper aerodigestive tract (UADT; eg, oral cavity, oropharynx and larynx), major salivary glands, nasal cavity, paranasal sinuses, skull base and…

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Summary

The cost of major head and neck cancer surgery is unknown. In this study, 245 patients underwent major head and neck cancer surgery over a five-year period at the cost of NZ$5,130,639.00, averaging NZ$20,941.38 per patient. There are many different types of head and neck cancers. The cost of treatment varies depending on the type of cancer. Calculated hospital income merely covered the actual cost of major HNC surgery, which places substantial financial burden on the hospital.

Abstract

Aim

This study quantified the cost of major head and neck cancer (HNC) surgery.

Method

Consecutive patients undergoing major HNC surgery between July 2007 and June 2012 were identified from our head and neck database. Patient demographics, tumour type, site, stage and types of resection and reconstruction, length of stay and surgical complications occurring within six months of initial surgery were retrospectively analysed. The actual cost of initial surgical treatment and hospital income were calculated.

Results

Two hundred and forty-five patients underwent major HNC surgery, most commonly for mucosal squamous cell carcinoma (SCC) and metastatic and/or locally advanced cutaneous SCC. Neck dissection and parotidectomy were the commonest resection procedures and free flaps the commonest reconstructive procedures performed. Forty-two patients developed surgical complications within six months of the initial major HNC surgery. Over the five-year period, surgery cost a total of NZ$5,130,639.00, averaging NZ$20,941.38 per patient, not including costs such as incidentals, while the hospital received NZ$4,976,559.61 averaging NZ$20,229.91/patient. On average, oral cavity cancer, metastatic and/or locally advanced skin cancer, and skull base cancer cost NZ$22,694.72/patient, NZ$17,373.64/patient and NZ$47,295.95/patient, respectively.

Conclusion

Calculated hospital income marginally covered the actual cost of major HNC surgery, which places substantial financial burden on the hospital. The anatomic site of the tumour determines the cost of treatment.

Author Information

Rahul Jayakar, Wellington Regional Plastic, Maxillofacial and Burns Unit, Hutt Hospital; Jenny Choi, Gillies McIndoe Research Institute, Wellington; Craig MacKinnon, Wellington Regional Plastic, Maxillofacial and Burns Unit, Hutt Hospital; Swee Tan, Wellington Regional Plastic, Maxillofacial and Burns Unit, Hutt Hospital; and Gillies McIndoe Research Institute, Wellington.

Acknowledgements

We thank Sharon Morse, data analyst, at Hutt Hospital for her assistance in the analysis of the cost of major HNC surgery and hospital income in this study. Jenny Choi was supported by the Summer Student Scholarship at the Gillies McIndoe Research Institute.

Correspondence

Swee Tan, Gillies McIndoe Research Institute, Wellington.

Correspondence Email

swee.tan@gmri.org.nz

Competing Interests

Nil.

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