Direct Medical Expenses of Cancer Patients Undergoing Surgery in Ahvaz Teaching Hospitals

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Extended Abstract
Background
Cancers are showing a rising trend in developing countries. In Iran, cancer is the third leading cause of death after cardiovascular diseases and accidents. The financial security of patients is at risk due to the high costs of cancer treatment, and the possibility to face catastrophic expenditure is extremely high for them. Also, the cost of cancer diagnosis and treatment imposes a heavy financial burden on health systems, requiring accurate financial assessments and evaluations. Due to the lack of resources in the healthcare sector, it is necessary to predict and plan carefully to use these resources in providing services. Therefore, this study aimed to determine the direct medical expenses of cancer patients undergoing surgery in Ahvaz, Iran, teaching hospitals.
Methods
This descriptive-analytical cross-sectional study was conducted in 2021. The research population included cancer patients undergoing surgery in Ahvaz teaching hospitals. The sample size was calculated at 203 patients, and these patients were randomly selected from the clinical records of patients who underwent surgery due to cancer. The including criteria were performing surgery on the patient in the hospital to treat cancer. Data collection was done by examining the clinical records of these patients, and necessary information including costs, demographic characteristics, and other items, was extracted. Finally, quantitative statistical indicators such as frequency, mean, standard deviation, and tables were used for data analysis. In addition, analytical statistical indicators such as independent-samples t-test, one-way analysis of variance (ANOVA), Pearson correlation coefficient, and regression were used with SPSS22 software.
Results
The clinical records of 199 cancer patients who underwent surgery were studied in this research. Most patients had uterine cancer (46 cases) and the least was skin cancer (7 cases). According to the study results, the overall mean costs for cancer surgery were calculated at 77,994,903 (SD= 111,224,332) IRR. The most expensive cancer surgery was colorectal cancer with an average of 193,558,434 (SD= 266,162,757) IRR, and the lowest cost was pancreatic cancer surgery with an average of 29,284,226 (SD= 23,057,425) IRR. Linear regression showed a significant positive relationship between the type of cancer and the length of hospital stay and the cost of hospitalized patients.
Conclusion
The economic costs of treating all cancers are burdensome and impose heavy economic pressure on patients and the health systems. It requires appropriate planning and policies to reduce probability of facing catastrophic health expenditures for cancer patients. Therefore, any therapeutic and administrative measure including adequate financial support from the government, insurance companies, and associations, will contribute significantly to reducing the patient’s sufferings, improving their quality of life, and reducing imposed costs. Also, considering the relationship between the length of hospital stay and the costs of hospitalized patients, the implementation of policies to reduce the length of stay and early diagnosis of cancer to reduce costs without harming the quality and quantity of services should be on the agenda of hospitals, as well as health sector policymakers.