Costs in primary care of investigating symptoms suspicious of cancer in a defined population

Figures & data

Table I.  Cost of investigations, expressed in SEK, related to the most frequently settled ICD codes. Less frequently ICD codes were merged with “Others”.

Diagnosis	Number of recorded codes	Chemical laboratory	Bacterial laboratory	X-ray	Referral	Endoscopy	Total cost per code	Cost per code and patient	Cost per code
Colorectal cancer
Abdominal pain	1086	63 979	12 878	375 676	77 747	43 254	573 534	730	528
Irritable colon	369	58 363	4163	91 874	8072	11 178	173 650	681	471
Unspecified disease digestive organs	125	16 741	1154	23 225	9467	5346	55 933	628	447
Tiredness	109	30 532	1300	5338	5370	486	43 026	483	395
Constipation	226	11 312	2428	47 201	3070	12 636	76 647	451	339
Anaemia	340	58 642	547	32 869	14 160	16 038	122 256	661	360
Anal fissure, fistula and abscess	107	733	433	15 726	7600	32 562	57 054	713	533
Vertigo	887	77 545	5560	41 365	50 533		175 003	279	197
Others	499	41 976	5691	153 052	34 376	40 824	275 919	436	553
Total	3748	359 823	34 154	786 326	210 395	162 324	1 553 022	601	414
Breast cancer
Total	163	2250	182	28 525	26 705	0	57 662	461	354
Broncho-pulmonary cancer
Asthma	1714	56 419	794	39 533	21 894		118 640	304	69
Other disease respiratory organ	168	2997	299	7416	22 621		33 333	222	198
Shortness of breath	415	11 063	2257	45 808	10 335		69 463	200	167
Pneumonia	619	5836	1844	59 828	3615		71 123	149	115
Bronchitis chronic	280	10 209		15 118	2180		27 507	133	98
Cough	420	18 344	3161	23 634	4904		50 043	129	119
Upper airway disease	3340	55 501	61 303	31 900	2219		150 923	50	45
Bronchitis acute	2146	30 503	1457	38 629	7200		77 809	46	36
Infection in epiglottis, larynx and trachea	114	708			1496		2204	14	19
Others	206	4666	91	14 670	17 898		40 325	262	196
Total	9422	196 246	71 206	276 536	94 382	0	638 370	88	68
Prostate cancer
Enlargement of the prostate gland	192	10 655	2466	7578	30 270	972	51 941	400	271
Urinary tract infection	232	3903	10 880	10 104	11 220		36 107	223	156
Prostatitis	353	6012	8795	3178	12 576	486	31 047	154	88
Others	358	15 112	17 035	31 821	33 853		97 821	400	273
Total	1135	35 682	39 176	52 681	87 919	1458	216 916	294	191
Unspecified tumour (tumour of unclear nature)
Total	73	2 761	91	25 222	22 141	0	50 215	913	688
Total all groups
Total	14 541	596 762	144 809	1 169 290	441 552	163 782	2516 185	235	173

*Very few visits first to the PHC for their breast problems and the ICD codes were therefore described together (see ref. [3]).

Figure 1.  Number and costs of laboratory examinations.

Figure 2.  Number and costs of X-ray/ultrasound/radiorenogram.

Table II.  Cost and cost-efficacy due to detected cancers of examinations performed related to the ICD codes vertigo/dizziness and tiredness/fatigue.

	Vertigo(780E)/ Dizziness(787A)		Tiredness/ Fatigue(780H)
Investigations	Cost/diagnostic code (SEK)	Cost/visit (n = 887) (SEK)	Cost/ICD code (SEK)	Cost/visit (n = 109) (SEK)
Laboratory examinations	83 105	94	31 832	292
B-Hb	5037	6	933	9
U-Dipslide	893	1	385	4
B-ESR	3391	4	1041	10
Liver tests	3085	3	987	9
Thyroid tests	19 734	22	9508	87
C-reactive protein + infectious tests	2620	3	646	6
Electrolytes	4736	5	3193	29
s-B12/folic acid	9526	11	2745	25
Electrophoresis	14 065	16	256	2
Borrelia	5096	6	0	0
Other	14 922	17	12 138	111
X-ray/ultrasound/examinations	41 365	47	5338	49
Chest	10 432	12	4238	39
Colon	4400	5	0	0
Abdom./u-sound	1956	2	652	6
CT brain	18 832	21	0	0
Other	5745	6	448	4
Endoscopy	0	0	486	4
Rectoscopy	0	0	0	0
Proctoscopy	0	0	0	0
Gastroscopy	0	0	486	4
Colonoscopy	0	0	0	0
Referrals	50 533	57	5370	49
Emergency dept	7254	8	0	0
Surgery	1944	2	972	9
Internal medicine	25 329	29	1612	15
Gastroenterology	0	0	0	0
Neurology	4992	6	1664	15
Other	11 014	12	2786	26
Total	175 003	197	43 026	395

Månsson J, Marklund B, Hultborn R. The diagnosis of cancer in the “roar” of potential cancer symptoms of patients in primary health care: Research by means of the computerised journal. Scand J Prim Health Care 2001; 19: 83–9

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