Analysis of public and private hospital databases (PMSI) 2010 / 2011 to estimate the frequency and associated costs for febrile neutropenia in France

Abstract

OBJECTIVE: Estimate the number and the cost of stay for patients hospitalized for chemotherapy-induced febrile neutropenia (FN) in the public and private sector hospitals in France. METHODS: The French Hospital National Database (PMSI) is a comprehensive database, which includes medical and administrative information (diagnoses and procedures) on all hospitalizations occurring annually, and to link records by patient. Hospital stays for patients admitted with newly diagnosed hematologic or solid malignancies were selected and an algorithm was used to identify patients hospitalized for chemotherapy-induced febrile neutropenia in 2010-2011. Economic valuation of these stays was made using national tariff. RESULTS: In 2010-2011, 13,559 stays for NF have been identified in 10,229 patients (1,894 patients with hematologic cancer and 8,343 patients with solid tumors). The incidence of FN hospitalisations among newly diagnosed patients receiving chemotherapy is estimated at 7.4%. Among the 13,559 stays, the 1,559 FN-related stays, 80% were solid tumor patients. FN was managed in public hospitals in 86% of cases and management was medical in 93% of cases. The mean length of stay was 6.3 days (±8.7). The average cost for FN amounted to € 3,921 (±€ 4747) per stay and € 5,198 (±€ 6,273) per patient during the one-year of follow-up, considering that one patient may be hospitalized several times during this period. CONCLUSION: The PMSI database is a useful source for estimating hospital costs of chemotherapy-induced febrile neutropenia in France. In 2010-2011, febrile neutropenia induced 13,559 hospital stays and a total cost of € 53.2 million for the health insurance.