Hospitalisations and Costs of Chronic Health Conditions Among Long-Term Survivors of Childhood, Adolescent, and Young Adult Cancers in Queensland, Australia.
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BACKGROUND: Adult cancer survivors are likely to be hospitalised with chronic illnesses, although evidence for childhood and AYA survivors is limited. AIM: This study quantified hospitalisations and the costs of health services used by survivors of childhood, adolescent, and young adult (AYA) cancers with and without chronic conditions. METHODS: We assessed long-term survivors (≥ 5 years past diagnosis) of childhood and AYA cancers diagnosed at ages 0-39 years between 1997 and 2011 in Queensland, Australia. Utilising a linked administrative dataset, we determined the prevalence of chronic conditions from hospital records using classification codes (ICD-10-AM) and quantified hospitalisations and associated costs in 2024 Australian dollars (AU$). Generalised linear regression modelling was used to examine how chronic conditions affected healthcare costs, controlling for clinical and socio-demographic factors. RESULTS: Of 14,422 participants, 16% (n = 2286) were hospitalised with at least one chronic disease, with hypertension (n = 675, 4.7%) and depression (n = 463, 3.2%) being the most common. Inpatient admissions were significantly higher for survivors with chronic conditions (mean 3, SD = 10) compared to those without chronic conditions (mean 1, SD = 4). The mean annual costs were highest for those with chronic kidney disease (AU$26,428, SD = AU$30,331), schizophrenia (AU$22,835, SD = AU$37,204), epilepsy (AU$22,361, SD = AU$37,224), paralysis (AU$22,051, SD = AU$32,165) and chronic heart failure (AU$21,912 SD = AU$38,763). Hypertension (AU$5.4 million) and depression (AU$4.3 million) incurred the highest total costs over the follow-up period. CONCLUSION: Implementing targeted survivorship care and preventative measures for high-cost conditions such as schizophrenia and chronic kidney disease may optimise healthcare resource use and reduce the economic burden for this population.