End-of-life healthcare use and associated costs for First Nations Australians diagnosed with cancer in Queensland, Australia

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dc.contributor.authorJahan, S.
dc.contributor.authorLindsay, D.
dc.contributor.authorDiaz, A.
dc.contributor.authorLi, M.
dc.contributor.authorGriffiths, K.
dc.contributor.authorOlver, I.
dc.contributor.authorGarvey, G.
dc.date.issued2025
dc.description.abstractPurpose: Cancer significantly impacts First Nations Australians, with higher incidence and lower survival rates. However, understanding of end-of-life (EOL) service use and costs in this population is limited. We aimed to assess EOL healthcare utilisation and costs for First Nations cancer patients in Queensland, Australia. Methods: Retrospective data from CancerCostMod, a linked administrative dataset of all cancer diagnoses in Queensland, were used. This dataset includes records from the Queensland Cancer Registry (QCR) from July 1, 2011, to June 30, 2015, linked to Queensland Health Admitted Patient Data Collection (QHAPDC), Emergency Department (ED) Information Systems, Medicare Benefits Schedule (MBS), and Pharmaceutical Benefits Scheme (PBS) data from July 2011 to June 30, 2018. All diagnosed cancer patients who had died during the study period (N = 467) were included. Health service usage and costs during the last 6 months of life were described and compared across care type, comorbidity status, age group, and residential remoteness using Mann–Whitney and Kruskal–Wallis tests. Results: Individuals had at least one hospital episode (100%), ED visit (83%), MBS claim (96%), and PBS claim (96%). The median overall cost per person for hospital episodes was AUD$40,996, with higher costs for those receiving palliative care (AUD$43,521) and chemotherapy (AUD$50,437) compared to those who did not receive these services (palliative: AUD$34,208, chemotherapy: AUD$38,557). Having comorbidities and living in regional and remote areas were associated with higher hospital costs. Conclusion: The study findings may guide the re-design and delivery of optimal and culturally appropriate EOL care for First Nations Australians diagnosed with cancer.
dc.description.statementofresponsibilityShafkat Jahan, Daniel Lindsay, Abbey Diaz, Ming Li, Kalinda Griffiths, Ian Olver, Gail Garvey
dc.identifier.citationSupportive Care in Cancer, 2025; 33(8):669-1-669-10
dc.identifier.doi10.1007/s00520-025-09725-x
dc.identifier.issn0941-4355
dc.identifier.issn1433-7339
dc.identifier.orcidOlver, I. [0000-0001-5478-1576]
dc.identifier.urihttps://hdl.handle.net/2440/147581
dc.language.isoen
dc.publisherSpringer
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT1153027
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/GNT20344531176651
dc.rights© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
dc.source.urihttps://doi.org/10.1007/s00520-025-09725-x
dc.subjectFirst Nations Australians; End-of-life care; Health care utilisation; Palliative care; Cancer costs
dc.subject.meshHumans
dc.subject.meshNeoplasms
dc.subject.meshTerminal Care
dc.subject.meshRegistries
dc.subject.meshRetrospective Studies
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshMiddle Aged
dc.subject.meshEmergency Service, Hospital
dc.subject.meshHealth Care Costs
dc.subject.meshPatient Acceptance of Health Care
dc.subject.meshQueensland
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshYoung Adult
dc.subject.meshAustralasian People
dc.titleEnd-of-life healthcare use and associated costs for First Nations Australians diagnosed with cancer in Queensland, Australia
dc.typeJournal article
pubs.publication-statusPublished online

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