To describe patients presenting with urologic complications following pelvic radiation
therapy and estimate the financial costs incurred in their treatment.
Patients and methods
In the year ending June 2018, all urology admissions at Royal Newcastle Centre were
reviewed for diagnostic codes pertaining to urethral or ureteric strictures, cystitis,
and haematuria. Presentations were complications following radiotherapy if a diagnosis
of radiation cystitis or stricture was recorded, and there was relevant prior radiotherapy.
The Independent Hospital Pricing Authority's National Weighted Activity Unit (NWAU)
2018 calculators, admission data and the National Efficient Price were used to estimate
costs of care. HNELHD HREC granted ethics approval (AU201808-10).
Complications following radiotherapy accounted for 65 admissions in 53 discrete patients,
accounting for 206 bed days and 3.7% of the 1748 total urology admissions in 1 year.
The majority (86%) of admissions had at least 1 operation. Mean time since radiotherapy
was 7 years (range 1-30). Mean number of operations related to complications following
radiotherapy was 3 (range 0-11). Readmissions were more frequent (mean 1.9 admissions/year)
than other urology inpatients (mean 1.3 admissions/year, P < .001). Mean NWAU18 value was 4.12 (range 2-8.3). Admission and procedure costs
were AUD $1,346,700, secondary malignancies were $9,000 and emergency department costs
were $45,864 for a combined total of $1,401,591.
Patients requiring urological admission with complications following radiotherapy
use more resources, stay for longer, have more operations and return more frequently
than other urology patients. Conservative estimates of cost $25,900 per patient in
the study year alone.