Premium
Endoscopic submucosal dissection for gastric cancer in elderly J apanese patients: An observational study of financial costs of treatment based on a national administrative database
Author(s) -
Murata Atsuhiko,
Muramatsu Keiji,
Ichimiya Yukako,
Kubo Tatsuhiko,
Fujino Yoshihisa,
Matsuda Shinya
Publication year - 2014
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12106
Subject(s) - medicine , endoscopic submucosal dissection , confidence interval , elderly people , medical costs , medical record , observational study , cancer , medical information , odds ratio , logistic regression , database , surgery , emergency medicine , gerontology , family medicine , health care , economics , economic growth , computer science
Objective There is currently little information on the medical economic outcomes of endoscopic submucosal dissection ( ESD ) for gastric cancer (GC) in elderly patients. This study therefore aimed to investigate the medical economic outcomes of ESD in elderly patients with GC using a national administrative database. Methods A total of 27 385 patients treated with ESD for GC were referred to 867 hospitals in J apan from 2009 to 2011. We collected data from the national administrative database and divided them into two groups according to age: elderly patients (≥80 years; n = 5525) and non‐elderly patients (<80 years; n = 21 860). We compared ESD ‐related complications, risk‐adjusted length of stay ( LOS ) and medical costs during hospitalization between elderly and non‐elderly patients.Results There was no significant difference in ESD ‐related complications between elderly and non‐elderly patients (4.3% vs 3.9%, P = 0.152). However, significant differences were observed in mean LOS and medical costs during hospitalization between the two groups ( P < 0.001). Multiple linear regression analysis showed that elderly patients experienced a significantly longer LOS and higher medical costs. The unstandardized coefficient for LOS in elderly patients was 2.71 days (95% confidence interval [ CI ] 2.59–2.84, P < 0.001), while that for medical costs during hospitalization was USD 952.1 (95% CI 847.7–1056.5, P < 0.001). Conclusions LOS and medical costs during hospitalization were significantly higher in elderly patients undergoing ESD for GC than in non‐elderly patients, although there was no difference in the incidence of ESD ‐related complications.