Current status of lung cancer in Spain: a retrospective analysis of patient characteristics, use of healthcare resources and in-hospital mortality

Abstract

Objective: This study aimed to describe the current status of lung cancer in Spain, including patient characteristics and in-hospital mortality, and to revise disease management and the direct medical costs of secondary care.

Methods: A retrospective observational study was set to analyse anonymized primary and secondary care records of patients admitted with lung cancer in Spain between 2011 and 2016. Data were obtained from the Primary Care Dataset and the Centralised Hospital Discharge Database.

Results: Admissions files from 12,119 primary care and 113,574 secondary care patients were analyzed. Only 21% of all patients were females, yet the number of female patients presented an increasing trend over the study period. Non-small-cell lung carcinoma represented 85.29% of all lung malignant neoplasms; metastatic or secondary malignant neoplasms were diagnosed in 76.66% of admissions. Other relevant comorbid conditions registered at the hospital level were hypertension, disorders of lipoid metabolism, diabetes mellitus and a history of tobacco use. In-hospital mortality was 22% over the study period and was associated with respiratory failure. Mean hospitalization time was 9.57 days and most admissions were due to emergencies. The mean cost of secondary care per patient was €8475, increasing significantly over the study period. Cost per patient was higher in those diagnosed with a squamous cell carcinoma.

Conclusions: Preventive and early detection measures are recommended, continuing to focus on females. In parallel, a multidisciplinary approach could optimize patient journey considering the presence of disease comorbidities, although its role in lung cancer mortality should be further explored.

Keywords:

• Lung neoplasms
• retrospective studies
• disease management
• costs and cost analysis
• Spain

Notes

Transparency

Declaration of funding

The authors received no specific funding for this work.

Declaration of financial and other interests

The authors have declared that no competing interests exist. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors contributions

JD contributed to the investigation by analyzing and interpreting the economic situation of lung cancer in Spain and was a major contribution in the intellectual content revision. AM analyzed the evolution of lung cancer management over the study period and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.

Acknowledgements

Not applicable.

Ethics approval and consent to participate

Parameters identifying the medical history and health centres were re-coded prior to extraction to avoid any access to identifying information in accordance with the principles of Good Clinical Practice and the Declaration of Helsinki. In such cases the Spanish legislation does not require patient consent and ethics committee approval according to the Law 14/2007, 3 July, on biomedical research, Spain. Patients were not directly involved in the research or the study design.

Data availability statement

The data that support the findings of this study is available from the Spanish Ministry of Health via the Unit of Health Care Information and Statistics (Spanish Institute of Health Information) for researchers who meet the criteria for access to confidential data at https://www.mscbs.gob.es/estadEstudios/sanidadDatos/home.htm

Notes

i StataCorp LP. 2011. Stata Statistical Software: Release 12. College Station, TX, USA.

ii Microsoft Corporation, Redmond, WA, USA.