Hospitalization rate and costs in acute lymphoblastic leukemia of childhood in a low‐income group: Financial impact in Northeast Mexico

• Published in: Pediatric blood & cancer Vol. 64; no. 12
• Main Authors: Jaime‐Pérez, José Carlos, Fernández, Lucía Teresa, Jiménez‐Castillo, Raúl Alberto, Colunga‐Pedraza, Julia Esther, Padilla‐Medina, José Ramón, Mancías‐Guerra, Consuelo, Gómez‐Almaguer, David
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.12.2017
• Subjects: Acute lymphoblastic leukemia; Adolescent; Cancer; Child; Child, Preschool; Children; Costs; Female; Hematology; Hospital Costs; hospitalization; Hospitalization - economics; Hospitalization - statistics & numerical data; Humans; Income; Infant; Intensive Care Units, Pediatric; Length of Stay; Leukemia; Longitudinal Studies; Low income groups; low‐income; Lymphatic leukemia; Male; Oncology; Patients; Pediatrics; popular medical insurance; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Retrospective Studies; Risk groups; Mexico; length of stay; costs; hospitalization; acute lymphoblastic leukemia; popular medical insurance; low-income
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.26673

Background Acute lymphoblastic leukemia (ALL) is one of the main and most expensive and prolonged causes of hospitalization for childhood cancer. We describe the hospitalization rate and its costs for an open population with ALL in a low‐middle income country. Procedure We retrospectively analyzed 449 hospital admissions for 101 pediatric patients with ALL over 8 years. Clinical files and electronic databases were scrutinized to document causes, duration, readmission rate, costs, and outcome of each admission. Hospitalizations were divided into two categories: general pediatric ward and pediatric intensive care unit (PICU). Hospitalization rates and its costs per patient were estimated considering person‐time at risk. Results Patients had an admission rate of 2.09 hospitalizations per patient‐year and median length of stay per admission was 5 days. Most admissions occurred during the first 2 years from diagnosis. Mean cost per day was 239 US dollars (USD) and mean cost per stay was 2,246 USD versus 1,016 and 19,004 USD (P = 0.001) in the PICU, respectively. Total hospitalization cost per patient per year (PPPY) was 5,991 USD for high‐risk patients and 3,038 USD for standard‐risk patients. Patients between ages 1 and 9 years had a PPPY cost of $4,057; while for children younger than 1 year or older than 9 years, it was 7,463 USD. The popular medical insurance program covered 70% of hospitalizations and 63% of its total cost; patients contributed 2%, with the hospital absorbing 35%. Conclusions Hospitalizations for children with ALL were less expensive than in high‐income countries but had a significant cost to low‐income families and to the healthcare system.