Cross-country comparisons of health-care costs: The case of cancer treatment in the Nordic countries

• Published in: Health policy (Amsterdam) Vol. 115; no. 2; pp. 172 - 179
• Main Authors: Kalseth, Jorid, Halvorsen, Thomas, Kalseth, Birgitte, Sarheim Anthun, Kjartan, Peltola, Mikko, Kautiainen, Kirsi, Häkkinen, Unto, Medin, Emma, Lundgren, Jonatan, Rehnberg, Clas, Másdóttir, Birna Björg, Heimisdottir, Maria, Bjarnadóttir, Helga Hrefna, Køtlum, Jóanis Erik, Kilsmark, Janni, Halsteinli, Vidar
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.04.2014; Elsevier
• Subjects: Biological and medical sciences; Cancer; Cancer treatment; Cost; Cross-national analysis; Denmark - epidemiology; Diagnosis-Related Groups - economics; Diagnosis-Related Groups - statistics & numerical data; Drugs; Finland - epidemiology; Health administration; Health care; Health Care Costs - statistics & numerical data; Health costs; Health-care costs; Hospitals; Humans; Iceland - epidemiology; Individual differences; Internal Medicine; Medical sciences; Medical service; Medical treatment; Medicin och hälsovetenskap; Miscellaneous; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); National comparisons; Neoplasms - economics; Neoplasms - epidemiology; Neoplasms - therapy; Nordic countries; Norway - epidemiology; Patients; Prescriptions; Prevalence; Prices; Productivity; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries; Service provision; Sweden - epidemiology; Tumors; Scandinavia; Europe; Denmark; Sweden; Norway; Iceland; Finland; Cancer treatment; Health-care costs; National comparisons; Costs; Malignant tumor; Cross-national study; Treatment; Health economy; Healthcare; Economic aspect; Comparative study; Public health; Cancer
• ISSN: 0168-8510; 1872-6054; 1872-6054
• DOI: 10.1016/j.healthpol.2014.01.003

Abstract The objective of this study is to perform a cross-country comparison of cancer treatment costs in the Nordic countries, and to demonstrate the added value of decomposing documented costs in interpreting national differences. The study is based on individual-level data from national patient and prescription drug registers, and data on cancer prevalence from the NORDCAN database. Hospital costs were estimated on the basis of information on diagnosis-related groups (DRG) cost weights and national unit costs. Differences in per capita costs were decomposed into two stages: stage one separated the price and volume components, and stage two decomposed the volume component, relating the level of activity to service needs and availability. Differences in the per capita costs of cancer treatment between the Nordic countries may be as much as 30 per cent. National differences in the costs of treatment mirror observed differences in total health care costs. Differences in health care costs between countries may relate to different sources of variation with different policy implications. Comparisons of per capita spending alone can be misleading if the purpose is to evaluate, for example, differences in service provision and utilisation. The decomposition analysis helps to identify the relative influence of differences in the prevalence of cancer, service utilisation and productivity.