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Survival analysis of cancer patients in Portugal following the reference centre model implementation

Author

Listed:
  • Manuel Melo Mateus

    (Instituto Superior Técnico, Universidade de Lisboa)

  • Margarida Catalão-Lopes

    (Centre for Management Studies of Instituto Superior Técnico (CEG-IST), Instituto Superior Técnico, Universidade de Lisboa)

  • Rui Portugal

    (Universidade de Lisboa)

Abstract

Cancer has affected around eighteen million people all over the world in 2018. In Portugal, cancer was diagnosed in sixty thousand individuals during 2018, being the second leading cause of death (one in every four deaths). Following the European Directive 2011/24/EU, the Portuguese Health System has been recognizing oncology Reference Centres (RCs), which are focused on delivering best-in-class treatment for cancer patients. This paper performs a survival analysis of cancer patients in Portugal, having hospital episodes with discharge date after the official recognition, in 2016, of the first RCs for hepatobiliary, pancreatic, sarcomas and oesophageal cancer. The aim is to assess the impact of RCs on the survival probability of these patients. For each cancer type, survival curves are estimated using the Kaplan–Meier methodology, and hazard ratios are estimated for different covariates, using multivariate Extended Cox models. The results obtained support the implementation and encourage the further extension of the RC model for oncology in Portugal, as cancer patients treated in an oncology RC, overall, have a better survival probability when compared to patients who had no episode in an RC. These results are clearer for hepatobiliary and pancreatic cancer, but also visible for sarcomas and oesophageal cancer.

Suggested Citation

  • Manuel Melo Mateus & Margarida Catalão-Lopes & Rui Portugal, 2023. "Survival analysis of cancer patients in Portugal following the reference centre model implementation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(2), pages 157-168, March.
    • Handle: RePEc:spr:eujhec:v:24:y:2023:i:2:d:10.1007_s10198-022-01461-x
    DOI: 10.1007/s10198-022-01461-x
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    References listed on IDEAS

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    1. J.-Matthias Schulenburg & Martin Frank, 2015. "Rare is frequent and frequent is costly: rare diseases as a challenge for health care systems," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(2), pages 113-118, March.
    2. Lena Harries & Jill Gwiasda & Zhi Qu & Harald Schrem & Christian Krauth & Volker Eric Amelung, 2019. "Potential savings in the treatment pathway of liver transplantation: an inter-sectorial analysis of cost-rising factors," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(2), pages 281-301, March.
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    More about this item

    Keywords

    Reference centre; Cancer survival analysis; Kaplan–Meier method; Extended Cox models;
    All these keywords.

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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