# Healthcare Service Disparities in Cancer Rehabilitation and Treatment Costs in Japan: A Cross-Sectional Analysis of National Data

## TL;DR

This study examines how cancer treatments in Japan affect rehabilitation costs and finds that combining treatments can reduce these costs.

## Contribution

The study identifies how multimodal cancer treatments can mitigate rehabilitation costs, offering insights into integrated care strategies.

## Key findings

- Radiotherapy and chemotherapy increase rehabilitation costs, but their combination reduces these costs.
- Surgery shows significant year-to-year cost variations, while rehabilitation costs remain stable.
- Multimodal treatment strategies may help reduce financial burdens in cancer rehabilitation.

## Abstract

Background: Cancer rehabilitation is essential for addressing the physical, psychological, and social challenges associated with cancer treatment. It plays a crucial role in mitigating functional impairment and enhancing recovery. However, the patterns of its utilization in relation to different cancer treatment modalities remain insufficiently understood. This study aimed to analyze the utilization of cancer rehabilitation in Japan and examine its association with surgery, chemotherapy, and radiation therapy.

Methods: A cross-sectional study was conducted using standardized claims data ratio (SCR) scores from Japan's National Database (NDB) between 2017 and 2021. SCRs for surgery, chemotherapy, radiotherapy, and cancer rehabilitation costs were analyzed across regions. Statistical analyses included repeated-measures analysis of variance (ANOVA) and a mixed-effects model to assess the influence of treatment type on rehabilitation costs.

Results: Surgery showed significant year-to-year differences (p < 0.05), whereas rehabilitation, radiotherapy, and chemotherapy did not. Radiotherapy (p = 0.03) and chemotherapy (p = 0.01) increased rehabilitation costs, whereas the interactions between surgery and chemotherapy (p = 0.03) and between chemotherapy and radiotherapy (p = 0.01) significantly reduced costs, suggesting the potential cost-mitigating potential of multimodal treatment strategies.

Conclusions: This study demonstrated that although individual cancer treatments increase rehabilitation costs, treatment interactions can help mitigate these financial burdens, highlighting the importance of integrated care. Our findings support the incorporation of rehabilitation, including multidisciplinary approaches, into cancer survivorship care. Further research is needed to optimize rehabilitation planning based on treatment interactions to improve cost-efficiency and clinical outcomes.