Economic Burden of Selected Diagnostic Imaging Methods in Oral Cancer

Transcription

1 Pesquisa Brasileira em Odontopediatria e Clinica Integrada 2018, 18(1):e4174 DOI: ISSN SHORT COMMUNICATION Economic Burden of Selected Diagnostic Imaging Methods in Oral Cancer Martin Samohyl 1, Pavol Beno 2, Katarina Hirosova 1, Lubica Argalasova 1, Jana Jurkovicova 1 1Institute of Hygiene, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic. 2Departmento of Laboratory Medicine, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic. Author to whom correspondence should be addressed: Martin Samohyl, Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava, 24 Spitalska, Bratislava , Slovak Republic. Phone: martin.samohyl@fmed.uniba.sk. Academic Editors: Alessandro Leite Cavalcanti and Wilton Wilney Nascimento Padilha Received: 17 June 2018 / Accepted: 05 September 2018 / Published: 11 September 2018 Abstract Objective: To analyse of proportion and economic burden of selected diagnostic imaging methods of oral cancer according to quarters and average percentage differences in the Slovak population in the period Material and Methods: In this descriptive study, the data were retrieved from the information system of the largest public health insurance company on our request, which archives the cost and proportion of diagnostic imaging methods of oral cancer in Slovak population. It was evaluated 48,995 of selected diagnostic imaging methods (Computed Tomography [CT], Magnetic Resonance Imaging [MRI] and X-Ray) in the period Results: The most frequently used diagnostic imaging method of oral cancer was magnetic resonance imaging method every quarters in 2016 and 2017 ( %) with slightly increasing trend in period Mean economic burden of selected diagnostic imaging methods of oral cancer were 1,974,900 for MRI method, 598,187 for CT method and 5,394 for RTG method in Decreasing trend of economic burden of diagnostic imaging method was found in MRI method and CT method in period Conclusion: Our economic burden study provides a useful source for public health professional and clinicians in better understanding the economic burden of diagnostic methods in oral cancer. Keywords: Diagnostic Imaging; Mouth Neoplasms; Cost of Illnes. 1

2 Introduction In the study performed by GLOBCAN [1] oral cancer incidence rate was 1.5 per 100,000 inhabitatants (2.7 in males) and oral cancer mortality was 1.8 per 100,000 inhabitatants (2.1 in males) in the world [1]. Worldwide, oral cancer is in the 11th place in malignant tumors [2]. The high oral cancer incidence rate was reported in Brazil, Pacific region, Western Europe (France), Eastern Europe (Hungary, Slovenia and Slovakia) [3]. It can be used various imaging techniques in oral cancer diagnostics: computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), cone beam computed tomography (CBCT), orthopantomography (OPG), X-Ray (RTG) [4] and others [5]. Dentist plays an important role in early detection and diagnostics of oral cancer [6]. The association between early detection and oral cancer prevalence is unclear [7]. Nurses and doctors pay attention more other body parts than the mouth [8]. The main risk factors of oral cancer include tobacco (smoking), age, human papilloma virus infection, alcohol consumption, race, socioeconomic status and others [9-12]. There are one public health insurance company (the most insured clients) and two small commercial health insurance companies in Slovakia. Every Slovak citizen must have health insurance according to Slovak law, to which he gives 4.0% of the gross income and the employer 10.0% of the gross income. The aim of this study was analyse of proportion and economic burden of selected diagnostic imaging methods of oral cancer according to quarters and average percentage differences (APD) in the Slovak population. Material and Methods Study Design In this descriptive study, the data were retrieved from the information system of the largest public health insurance company on our request, which archives the cost and proportion of diagnostic imaging methods of oral cancer in Slovak population. It was evaluated 48,995 of selected diagnostic imaging methods (CT, MRI and RTG) in the period Statistical Analysis For statistical evaluation of proportion (percentages), APD and economic burden of selected diagnostic imaging methods it was used SPSS Software, version 24 (IBM Corp., Armonk, NY, USA). Results Proportion of selected diagnostic imaging methods of oral cancer according to quarters and average percentage differences, can be seen in the Table 1. The significant decrease of APD of oral cancer was observed in RTG method in quarter between 2016 and 2017 (APD %). The most frequently used diagnostic imaging method of oral cancer was MR method every quarters in 2016 and 2017 ( %) with slightly increasing trend in period (Figure 1). 2

3 Table 1. Proportion of selected diagnostic imaging methods in oral cancer according to quarters and average percentage differences, (n=48,995). Diagnostic Year Quarters Imaging Method APD 1 N % N % % CT 5, , MR 6, , RTG * CT 4, , MR 6, , RTG Average percentage differences; * p<0.05. Figure 1. Percentage of selected diagnostic imaging methods in oral cancer. Economic burden of selected diagnostic imaging methods of oral cancer according to quarters and APD, are given in Table 2. Mean economic burden of selected diagnostic imaging methods of oral cancer were 1,974,900 for MR method, 598,187 for CT method and 5,394 for RTG method in Economic burden of MR method the significant decrease (APD %) in quarter in 2017 in comparison with the same quarter in Decreasing trend of economic burden of diagnostic imaging method was found in MR method and CT method in period (Figure 2). Table 2. Economic burden ( ) of selected diagnostic imaging methods in oral cancer according to quarters and average percentage differences, (n=48,995). Quarters Diagnostic Economic Burden Imaging Method APD 1 % % % CT 406, * 320, MR 1,171, ,033, RTG 3, , CT 377, * 278, MR 1,084, * 941, RTG 2, , Average percentage differences; * p<

4 Figure 2. Economic burden of selected diagnostic imaging methods in oral cancer. Discussion According to our knowledge and available sources in the literature, the present economic burden study is the first study, which analysed economic burden of CT, MR and RTG method in oral cancer in the Slovak population. Generally, there is a limited number of studies analysing proportion and economic burden of diagnostic imaging methods used in detection/diagnosis of oral cancer. Computed tomography is one of the important diagnostic methods used in patients with oral cancer. Computed tomography probably better detects of cervical lymphadenopathy than clinical examination [13]. While APD proportion of CT method decreased only about -2.2%, APD of economic burden decreased by -26.3% (p<0.05) in Slovak population between quarter of 2016 and quarter of Magnetic resonance is one of the imaging techniques, which provides imaging of soft tissues (the highest quality) without biological risks [14]. The highest economic burden from selected diagnostic imaging method of oral cancer was found in MR method with decrease in While APD proportion of RTG method decreased, APD of economic burden increased between quarter in 2016 and quarter in It can be partly explained by the health insurance company increases the cost on RTG method and the health insurance company indirectly increase pressure on oncologists and dentists to use more accurately diagnostic methods in detection of oral cancer. Conclusion This economic burden study was performed on 48,995 of selected diagnostic imaging methods for diagnostics of oral cancer in Slovak population. The highest economic burden and the most frequently used diagnostic imaging methods for detection and diagnostics of oral cancer in Slovak population was MR method. Our economic burden study provides a useful source for public 4

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