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Record W3011488375 · doi:10.12927/hcpol.2020.26129

Comparing Childhood Cancer Care Costs in Two Canadian Provinces

2020· article· en· W3011488375 on OpenAlexafffundvenueabout
Mary L. McBride, Claire de Oliveira, Ross Duncan, Karen E. Bremner, Mark Greenberg, Paul C. Nathan, Stuart Peacock, Murray Krahn

Bibliographic record

VenueHealthcare policy · 2020
Typearticle
Languageen
FieldMedicine
TopicChildhood Cancer Survivors' Quality of Life
Canadian institutionsPediatric Oncology GroupUniversity Health NetworkHospital for Sick ChildrenUniversity of British ColumbiaCentre for Addiction and Mental HealthCanadian Centre for Applied Research in Cancer Control
FundersOntario Ministry of Health and Long-Term CareInstitute for Clinical Evaluative SciencesCancer Care Ontario
KeywordsChildhood cancerHealth careCancerMedical costsGeographyMedicineEnvironmental healthBusinessEconomic growthEconomics

Abstract

fetched live from OpenAlex

Background: Cancer in children presents unique issues for diagnosis, treatment and survivorship care.Phase-specific comparative cost estimates are important for informing healthcare planning.Objectives: The aim of this paper is to compare direct medical costs of childhood cancer by phase of care in British Columbia (BC) and Ontario (ON).Methods: For cancer patients diagnosed at <15 years of age and propensity-score-matched non-cancer controls, we applied standard costing methodology using population-based healthcare administrative data to estimate and compare phase-based costs by province.Results: Phase-specific cancer-attributable costs were 2%-39% higher for ON than for BC.Leukemia pre-diagnosis costs and annual lymphoma continuing care costs were >50% higher in ON.Phase-specific in-patient hospital costs (the major cost category) represented 63%-82% of ON costs, versus 43%-73% of BC costs.Phase-specific diagnostic tests and procedures accounted for 1.0%-3.4% of ON costs and 2.8%-13.0% of BC costs.Conclusions: There are substantial cost differences between these two Canadian provinces, BC and ON, possibly identifying opportunities for healthcare planning improvement. RésuméContexte : Le cancer chez l' enfant présente des problèmes uniques en matière de diagnostic, de traitement et de survie.Il importe d' effectuer une comparaison portant sur l' estimation des coûts, selon des étapes précises, pour renseigner la planification des services de santé.Objectif : L' objectif de cet article est de comparer les coûts médicaux directs du cancer chez l' enfant, selon les étapes de soins, en Colombie-Britannique et en Ontario.Méthode : Pour les patients qui ont reçu un diagnostic de cancer avant l'âge de 15 ans et pour le groupe témoin de personnes non cancéreuses au score de propension similaire, nous avons employé une méthodologie standard pour le calcul des coûts au moyen des données administratives de santé afin d' estimer et de comparer, étape par étape, les coûts dans les provinces.Résultats : Les coûts attribuables au cancer pour les étapes à l'étude étaient de 2 à 39 % plus élevés en Ontario qu' en Colombie-Britannique. Les coûts pré-diagnostics associés à la leucémie et les coûts annuels pour un lymphome étaient >50 % plus élevés en Ontario.Les coûts des patients hospitalisés pour les étapes à l'étude (la principale catégorie de coûts) représentaient de 63 à 82 % des coûts en Ontario, contre 43 à 73 % en Colombie-Britannique. Les tests et procédures diagnostiques pour les étapes à l'étude comptaient pour 1,0 à 3,4 % des coûts en Ontario, contre 2,8 à 13,0 % en Colombie-Britannique. Conclusion : Il y a d'importantes différences de coûts entre les deux provinces canadiennes, l'Ontario et la Colombie-Britannique, ce qui laisse possiblement place à une amélioration dans la planification des services de santé.

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How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.009
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.874
Threshold uncertainty score0.912

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0020.009
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0050.011
Science and technology studies0.0030.001
Scholarly communication0.0020.001
Open science0.0020.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.061
GPT teacher head0.401
Teacher spread0.340 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations8
Published2020
Admission routes4
Has abstractyes

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