Comparison of Top down and Bottom up Cost Approaches in Colon and Rectal Cancer Treatment

Abstract

Introduction: In recent years, health care expenditures have significantly risen across the world and in Turkey. Because of the limited resources allocated to health, it is very important for countries to conduct studies especially on cost of diseases such as colorectal cancer (CRC) with a high burden of disease and labor loss. The aim of this study was to calculate the cost of treatment for colon and rectal cancers based on two different cost approaches from the perspective of SSI (top-down and bottom-up) and to compare the results obtained. Materials and Methods: Data were obtained from the SSI MEDULA System a total of 62,970 colon and rectal cancer patient for the top-down cost approach. In the bottom-up cost approach, treatment costs were determined based on the expert opinions. Results: The average cost of treatment per patient for colon cancer was determined as 3055.5 TL, for rectal cancer was determined as 4146.2 TL with the top-down cost approach. The average cost of treatment per patient for colon cancer was determined as 14,920.4 TL, for rectal cancer was determined as 17,904.6 TL according to the bottom-up cost approach. Conclusion: Since the bottom-up cost approach provides more detailed information on the cost of illness, and thereby on the use of resources allocated to health, it is thought that the combined use of these two cost approaches completes each other’s weaknesses.