# Hospitalisations and Costs of Chronic Health Conditions Among Long‐Term Survivors of Childhood, Adolescent, and Young Adult Cancers in Queensland, Australia

## TL;DR

This study examines hospitalizations and healthcare costs for long-term cancer survivors in Queensland, finding that chronic conditions like hypertension and depression significantly increase healthcare use and costs.

## Contribution

The study provides new evidence on the impact of chronic conditions on hospitalization rates and healthcare costs among childhood and young adult cancer survivors.

## Key findings

- 16% of cancer survivors were hospitalized with chronic diseases, with hypertension and depression being most common.
- Survivors with chronic conditions had higher inpatient admissions and higher mean annual healthcare costs.
- Conditions like chronic kidney disease and schizophrenia incurred the highest individual healthcare costs.

## Abstract

Adult cancer survivors are likely to be hospitalised with chronic illnesses, although evidence for childhood and AYA survivors is limited.

This study quantified hospitalisations and the costs of health services used by survivors of childhood, adolescent, and young adult (AYA) cancers with and without chronic conditions.

We assessed long‐term survivors (≥ 5 years past diagnosis) of childhood and AYA cancers diagnosed at ages 0–39 years between 1997 and 2011 in Queensland, Australia. Utilising a linked administrative dataset, we determined the prevalence of chronic conditions from hospital records using classification codes (ICD‐10‐AM) and quantified hospitalisations and associated costs in 2024 Australian dollars (AU$). Generalised linear regression modelling was used to examine how chronic conditions affected healthcare costs, controlling for clinical and socio‐demographic factors.

Of 14,422 participants, 16% (n = 2286) were hospitalised with at least one chronic disease, with hypertension (n = 675, 4.7%) and depression (n = 463, 3.2%) being the most common. Inpatient admissions were significantly higher for survivors with chronic conditions (mean 3, SD = 10) compared to those without chronic conditions (mean 1, SD = 4). The mean annual costs were highest for those with chronic kidney disease (AU$26,428, SD = AU$30,331), schizophrenia (AU$22,835, SD = AU$37,204), epilepsy (AU$22,361, SD = AU$37,224), paralysis (AU$22,051, SD = AU$32,165) and chronic heart failure (AU$21,912 SD = AU$38,763). Hypertension (AU$5.4 million) and depression (AU$4.3 million) incurred the highest total costs over the follow‐up period.

Implementing targeted survivorship care and preventative measures for high‐cost conditions such as schizophrenia and chronic kidney disease may optimise healthcare resource use and reduce the economic burden for this population.