[A study based on national DRG data to evaluate work load, practice and cost relating to paediatric oncology in...

To assess if our methodology previously used for all cancers remains valid when only 1% of cancers are analysed, we used childhood cancer in French hospitals based on national DRG data.

With a specific algorithm we extracted from the 1999 national DRG data (16,539,352 hospitalisations) the cancer data (2,947,471 hospitalisations) and the reduced cancer data (2,711,025 hospitalisations). We used this reduced cancer data to identify the 77 350 hospitalisations for childhood cancers.

The majority of hospitalisations (83%) and the Activity Synthetic Index (ISA) for childhood cancers are concentrated on University hospitals and regional cancer centres. The cost of childhood cancers was estimated to be 136 million euros, with haematology costing 60 million euros. Chemotherapy, which accounted for almost 50% of the ISA is the predominant therapy.

Our results appear to be consistent with the incidence and the clinical practices described by the population registries and the registry of the French Society for Paediatric Oncology. They correspond also with the organisation of the care of those patients which converges towards the global care of the patient in which the concept of health networks and patient's trajectories are pivotal. However, an investigation inside the hospitals is required to see if our results correspond with the reality. This is the objective of our next study.