Evaluation of the treatment and hospital costs for head and neck cancer

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As the medical costs of treating head and neck cancer increases, it is necessary to evaluate the costs of treatment so that resources may be better allocated. We present our 12 year experience in the treatment of hypopharyngeal cancer at Nihon University Itabashi Hospital with respect to clinical outcomes and hospital costs.Medical records of 44 patients diagnosed with hypopharyngeal cancer between 1986 and 1997 were reviewed. Clinical outcome parameters as well as treatment cost parameters were analyzed. Mean hospital costs was ・4,323,300 with a median of, 830, 710 (913, 490-15, 284, 080). Total hospitalization days averaged 128.8 days with a median of 126.5 days (31-400).The major components of hospitalization consisted of admission costs (32%), oral or 1V medication (25%), surgical costs (17%), examination costs(9%), imaging and diagnostic studies (7%). Depending on the treatment modality provided, surgical costs played a key role in determining the total hospital cost differences between patients. The major component of medication was for parenteral nutrition.Addition of chemotherapy to the treatment did not significantly impact on total cost. In spite of an initial increase of surgical costs, free jejunum reconstruction of the hypopharynx resulted in overall reduction of hospitalization, total hospital costs, and improved quality of life for the patients.