Hospital Incidence and Medical Costs of Female Breast Cancer in Spain: A Retrospective Multicenter Study

Abstract

Background: Breast cancer is the most prevalent cancer in women worldwide, causing the greatest number of cancer-related deaths. This study aimed to evaluate the use of healthcare resources associated with female breast cancer in Spain, to analyze trends in hospitalization and death rates, and the related direct medical costs. Methods: A retrospective multicenter study analyzed records of hospital and ambulatory visits of women diagnosed with breast cancer in Spanish hospitals between 1st January 2005 and 31st December 2018. Results: In total, 353,080 admission files were reviewed, mainly inpatient hospital admissions, corresponding to 299,585 individual patients. The median patient age was 59 years, 12.7% of admissions registered the presence of metastatic tumors, and 15.7% registered unspecified secondary tumors. The mean in-hospital death rate was 3.0% for patients without a metastatic disease and 10.5% for patients with metastatic disease, decreasing significantly over the study period. The total ageadjusted hospitalization rate increased between 2005 and 2011 and decreased after 2012. The mean direct medical cost was 3824 per outpatient visit, 3995 per hospital admission up to 3 days and 5001 per hospital admission over 3 days. Admission costs increased in patients with metastatic disease and those deceased during hospitalization. Conclusion: This study supports previous findings regarding the relative increase in breast cancer incidence that could be attributed to the intensive screening and the reduction in the death rate. Mean direct medical cost in this study varied greatly with the length of stay, presence of metastatic tumors and disease fatality.