BACKGROUND: Cancer is one of the diseases with the greatest burden, out of which close to 56% of incident cases and 62% of deaths were reported in developing countries. Cancer treatment includes the use of surgical methods, chemotherapy, and radiation therapy. There is significant economic burden on patients from developing countries to treat cancer and the majority of them do not have insurance coverage. There is considerable interest in understanding the resource utilization and costs among cancer patients and assessing disparities in patients with different payers.

OBJECTIVES: The objectives of this study were: 1) to analyze the health care resource utilization and costs of patients treated for breast, oral, and ovarian cancer in a tertiary hospital in India, and 2) to evaluate the effect of the type of payer on health care utilization and cost of patients treated for breast, oral, and ovarian cancer in a tertiary hospital in India.

METHODS: Health resource utilization and costs data was obtained from the electronic medical record database of a tertiary hospital in Mumbai, India. Descriptive analysis, t-tests and chi-square tests were performed in the analysis. Simple and multiple linear regression models were run to assess the association between age, length of stay, number of clinician visits, payer type, patient type, comorbidities, cancer stage, and gender with total treatment cost.

RESULTS: For private insurance patients, the mean length of stay was highest among patients with breast (6.4+1.8 days) and ovarian (10.5+3.9 days) cancer, and for patients below the poverty line, it was the highest (11.0+2.8) among oral cancer patients. For patients with private insurance the highest number of per patient clinician visits were among breast (16.3 visits) and oral cancer (36.5 visits) patients, while those with no insurance had the highest number of per patient clinician visits among ovarian cancer (34.2 visits) patients. Among patients with oral and ovarian cancer, patients with no insurance received the highest number of unit doses of drugs, while patients with private insurance received the highest number of unit doses of drugs among breast cancer patients. Mean hospital costs were the highest for private insurance patients among breast ($2381.03+1739.31), oral ($5132.61+6158.41), and ovarian ($2735.00+2454.62) cancer patients. Among all the three cancer types in the study, patients with an advanced cancer stage incurred higher mean total costs than patients with early stage cancer. Surgical oncologist charges were the highest for breast, oral, and ovarian cancer patients.

CONCLUSIONS: Significant differences in resource utilization and costs were found in breast, oral, and ovarian cancer patients. Patients with private insurance and those paying out-of-pocket incurred higher costs but they used more resources in the hospital.