Factors associated with the costs of hospitalization after esophagectomy: a retrospective observational study at a three-tertiary cancer hospital in China.

Background: Esophageal cancer represents a major health threat in China. Esophagectomy is the standard treatment for respectable esophageal cancer. This study aimed to investigate the costs of hospitalization in esophageal cancer patients undergoing esophagectomy, and to analyze the factors influencing these costs.

Methods: A retrospective observational study which enrolled 196 patients who underwent esophagectomy from September, 2018, to April, 2019, in the Affiliated Cancer Hospital of Zhengzhou University were conducted.

Results: The median inpatient cost was ￥72,772 (range, ￥49,796-128,771). Materials accounted for 39.7% of the direct medical costs, which was the highest proportion for any of the cost components. Minimally invasive esophagectomy (MIE, OR: 0.031; 95% CI: 0.005-0.209), cardiopathy comorbidity (OR: 0.344; 95% CI: 0.136-0.872), and anastomotic leak (OR: 0.012; 95% CI: 0.001-0.131) were risk factors for higher cost, while early oral feeding (OR: 3.979; 95% CI: 1.430-11.067) was a protective factor.

Conclusions: Understanding the factors associated with high hospitalization costs will help to reduce healthcare expenditure. By controlling complications and promoting early oral feeding, the economic burden on esophagectomy patients can be relieved. Further research based on a longitudinal design is needed to investigate the full costs of hospitalization associated with esophageal cancer.