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Hospitalizations in Australian children with neuroblastoma: A population-based study
C Signorelli1,2, F J Schneuer3,4, C E Wakefield1,2
1Kids Cancer Centre, Sydney Children's Hospital, New South Wales, Randwick, Australia.
Insights
Neuroblastoma survivors face significant healthcare burdens, with frequent hospitalizations and high costs. Early intervention and long-term monitoring are crucial for optimizing care for these pediatric cancer patients.
Area of Science:
- Pediatric Oncology
- Health Services Research
- Epidemiology
Background:
- Increasing survival rates for pediatric neuroblastoma, encompassing both low- and high-risk cases.
- Intensive, multimodal treatments for neuroblastoma, particularly high-risk forms, lead to substantial long-term health issues.
- Need to characterize the post-treatment health journey of neuroblastoma survivors.
Purpose of the Study:
- To describe pediatric hospitalizations and readmissions among neuroblastoma survivors.
- To analyze the associated healthcare costs for neuroblastoma survivors.
- To identify patterns in readmissions and their primary causes.
Main Methods:
- Population-based study of children (<18 years) in New South Wales, Australia (2001-2020).
- Utilized linked Admitted Patient Data Collection and death registration data.
- Examined hospitalizations, length of stay, readmissions, and costs following the index neuroblastoma diagnosis admission.
Main Results:
- 300 children hospitalized for neuroblastoma; 64% were under 3 years old.
- Median of 17 readmissions and 45.5 days length of stay within 2 years post-discharge.
- Median cost per child was AUD$124,058, with 58% of readmissions occurring within 1 year, often for fever, nausea, abdominal pain, and respiratory issues.
Conclusions:
- Neuroblastoma survivors incur significant healthcare costs due to recurrent hospitalizations.
- There is a substantial burden of health problems requiring hospitalization among these survivors.
- Optimizing healthcare for neuroblastoma survivors necessitates early intervention and continuous long-term monitoring.
Background:
An increasing number of children diagnosed with both low- and high-risk neuroblastoma are surviving. Yet, treatment can be intensive and often multimodal, especially for high-risk neuroblastoma, resulting in significant long-term health problems. We aimed to describe neuroblastoma survivors' pediatric hospitalizations, readmissions, and their associated costs.
Method:
We conducted a population-based study of all children (<18 years) residing in New South Wales (NSW), Australia, and hospitalized with a recorded diagnosis of neuroblastoma during 2001-2020. We used linked NSW Admitted Patient Data Collection and death registration data to examine the frequency, length of stay, and readmissions following the first admission when neuroblastoma was diagnosed (i.e., the index admission), and the associated hospitalization costs by age and timing postindex admission discharge.
Results:
In total, 300 children (64% aged <3 years) were hospitalized for neuroblastoma over the study period. The median number of readmissions and length of stay within 2 years postdischarge were 17 (interquartile range IQR: 5.5-25) and 45.5 (IQR: 10-125) days, and median cost per child was AUD$124,058 (IQR $34,217-$264,627). Following discharge from the index admission, there were 7088 readmissions (median: 20 per child, IQR: 7-29). Fifty-eight percent of readmissions occurred within 1-year postdischarge, primarily due to fever, nausea, abdominal pain, and respiratory conditions.
Conclusion:
The burden of health problems requiring hospitalization among neuroblastoma survivors results in significant associated healthcare costs, warranting further efforts to optimize health care for neuroblastoma survivors that focuses on early intervention and long-term monitoring.
