Background: People with a history of cancer are at an increased risk of being hospitalised due to a chronic condition. This study examined chronic diseases leading to hospitalisation and quantified associated healthcare costs in long-term survivors of childhood and AYA cancer in Australia
Methods: This study included long-term survivors (>5 years) of childhood and AYA cancers diagnosed between 1997 and 2015 in Queensland, Australia. We assessed the prevalence of chronic health conditions from routinely collected hospital disease classification codes (ICD-10-AM) and quantified hospitalisation and costs (price year 2024). We used a generalised linear regression model with a log link function and gamma distribution to examine how chronic conditions affect healthcare costs, while controlling for other Clinical and demographic factors.
Results: Of the 14,422 individuals eligible for inclusion, 16% (n=2,286) were hospitalised with at least one chronic disease. The most common conditions were hypertension (n=675, 4.7%) and depression (n=463, 3.2%), particularly among young adults. Cancer survivors with chronic conditions had significantly higher annual mean hospital admissions (mean 3, SD: 10) and length of stay (mean 6.4, SD:15.3) than those without chronic conditions (mean admissions 1, SD 4 and 1.5 days of stay, SD 5.1). The mean costs were significantly higher for survivors with than without chronic conditions (AU$19,227, SD AU$36,957 vs AU$6,798, SDAU$1,905). The mean annual total costs were highest for those with chronic kidney disease AU$26,428 (SD $30,331) and schizophrenia AU$22,835 (SD $37,204) while cumulatively, hypertension (AU $5.4 million) and depression (AU $4.3 million) had the highest total cost. Having chronic kidney disease and schizophrenia significantly increased healthcare costs by 3.5-fold and 1.9-fold respectively.
Conclusion: Long-term survivors of childhood and AYA cancers can face hospitalizations and incur high healthcare costs due to chronic conditions. Further planning and chronic disease screening and management, may assist in optimizing health and cost outcomes.