Healthcare utilisation in patients with breast cancer or non-Hodgkin lymphoma who experienced febrile neutropenia in the Netherlands: a retrospective matched control study using the PHARMO database

Eur J Cancer Care (Engl). 2015 Mar;24(2):232-41. doi: 10.1111/ecc.12189. Epub 2014 Feb 14.

Abstract

Few data have been published on healthcare resource utilisation associated with chemotherapy-induced febrile neutropenia (FN) in Europe. Using the PHARMO record linkage system, we identified incident adult patients with a primary hospital discharge diagnosis of breast cancer (BC) or non-Hodgkin lymphoma (NHL) from 1998 to 2008. Patients who experienced FN were matched 1:2 non-FN reference patients. Of 1033 BC patients, 80 (8%) had FN and were matched with 160 reference patients; and of 486 NHL patients, 95 (20%) had FN and 89 were matched with 178 reference patients. Significantly more FN patients were hospitalised for any cause than reference patients: BC, 81% vs. 24% (OR 12.6; 95% CI 5.7-27.8); NHL, 82% vs. 44% (OR 6.7; 95% CI 3.3-13.9). Median length of all-cause hospitalisation stay was higher for FN patients: BC, 4.0 vs. 1.0 days; NHL, 8.5 vs. 1.8 days. The median (interquartile range) number of medication treatments was higher for FN patients: BC, 5.5 (4.0-7.5) vs. 2.0 (2.0-4.0); NHL, 8.0 (5.0-11.0) vs. 3.0 (2.0-4.0). In conclusion, FN in patients with BC or NHL had increased healthcare utilisation compared with non-FN patients; thus, efforts to reduce FN are warranted to reduce cost and improve outcomes.

Keywords: breast cancer; case-control study; chemotherapy-induced febrile neutropenia; healthcare resource utilisation; non-Hodgkin lymphoma.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / complications*
  • Breast Neoplasms / therapy
  • Case-Control Studies
  • Febrile Neutropenia / complications*
  • Female
  • Health Services / statistics & numerical data*
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Lymphoma, Non-Hodgkin / complications*
  • Lymphoma, Non-Hodgkin / therapy
  • Middle Aged
  • Niederlande
  • Odds Ratio
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Retrospective Studies