PMID- 37244434
OWN - NLM
STAT- MEDLINE
DCOM- 20230926
LR  - 20230927
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 42
IP  - 10
DP  - 2023 Oct
TI  - Contribution of skin cancer to overall healthcare costs of lung transplantation 
      in Queensland, Australia.
PG  - 1437-1444
LID - S1053-2498(23)01867-3 [pii]
LID - 10.1016/j.healun.2023.05.014 [doi]
AB  - BACKGROUND: Skin cancers are a major source of morbidity in lung transplant 
      recipients, but the relative costs associated with their treatment are unknown. 
      METHODS: We prospectively followed 90 lung transplant recipients from enrollment 
      in the Skin Tumors in Allograft Recipients study in 2013-2015, until mid-2016. We 
      undertook a cost analysis to quantify the health system costs relating to the 
      index transplant episode and ongoing costs for 4 years. Linked data from surveys, 
      Australian Medicare claims, and hospital accounting systems were used, and 
      generalized linear models were employed. RESULTS: Median initial hospitalization 
      costs of lung transplantation were AU$115,831 (interquartile range (IQR) 
      $87,428-$177,395). In total, 57 of 90 (63%) participants were treated for skin 
      cancers during follow-up at a total cost of AU$44,038. Among these 57, total 
      government costs per person (mostly of pharmaceuticals) over 4 years were median 
      AU$68,489 (IQR $44,682-$113,055) vs AU$59,088 (IQR $38,190-$94,906) among those 
      without skin cancer, with the difference predominantly driven by more doctors' 
      visits, and higher pathology and procedural costs. Healthcare costs overall were 
      also significantly higher in those treated for skin cancers (cost ratio 1.50, 
      95%CI: 1.09, 2.06) after adjusting for underlying lung disease, age on 
      enrollment, years of immunosuppression, and the number of treated comorbidities. 
      CONCLUSIONS: Skin cancer care is a small component of overall costs. While all 
      lung transplant recipients with comorbidities have substantial healthcare costs, 
      those affected by skin cancer incur even greater healthcare costs than those 
      without, highlighting the importance of skin cancer control.
CI  - Copyright (c) 2023 International Society for the Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Gordon, Louisa G
AU  - Gordon LG
AD  - QIMR Berghofer Medical Research Institute, Population Health Department, 
      Brisbane, Queensland, Australia; Queensland University of Technology, School of 
      Nursing, Institute of Health and Biomedical Innovation, Brisbane, Queensland, 
      Australia; The University of Queensland, School of Medicine, Brisbane, 
      Queensland, Australia. Electronic address: louisa.gordon@qimrberghofer.edu.au.
FAU - Hopkins, Peter M
AU  - Hopkins PM
AD  - The University of Queensland, School of Medicine, Brisbane, Queensland, 
      Australia; Queensland Lung Transplant Service, Prince Charles Hospital, 
      Queensland Health, Queensland Government, Brisbane, Queensland, Australia.
FAU - Chambers, Daniel C
AU  - Chambers DC
AD  - The University of Queensland, School of Medicine, Brisbane, Queensland, 
      Australia; Queensland Lung Transplant Service, Prince Charles Hospital, 
      Queensland Health, Queensland Government, Brisbane, Queensland, Australia.
FAU - Green, Adele C
AU  - Green AC
AD  - QIMR Berghofer Medical Research Institute, Population Health Department, 
      Brisbane, Queensland, Australia; CRUK Manchester Institute and Faculty of Biology 
      Medicine and Health, University of Manchester, Manchester Academic Health Science 
      Centre, Manchester, UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230525
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Humans
MH  - Aged
MH  - Queensland/epidemiology
MH  - Australia/epidemiology
MH  - National Health Programs
MH  - *Skin Neoplasms/surgery
MH  - Health Care Costs
MH  - *Lung Transplantation
OTO - NOTNLM
OT  - Direct healthcare costs
OT  - Healthcare costs
OT  - Keratinocyte carcinoma
OT  - Lung transplant
OT  - Skin cancer
EDAT- 2023/05/28 01:07
MHDA- 2023/09/26 13:44
CRDT- 2023/05/27 19:24
PHST- 2022/09/14 00:00 [received]
PHST- 2023/03/19 00:00 [revised]
PHST- 2023/05/20 00:00 [accepted]
PHST- 2023/09/26 13:44 [medline]
PHST- 2023/05/28 01:07 [pubmed]
PHST- 2023/05/27 19:24 [entrez]
AID - S1053-2498(23)01867-3 [pii]
AID - 10.1016/j.healun.2023.05.014 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2023 Oct;42(10):1437-1444. doi: 
      10.1016/j.healun.2023.05.014. Epub 2023 May 25.