{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:11:53Z","timestamp":1777561913618,"version":"3.51.4"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>For potentially curable esophageal cancer (EC) and gastric cancer (GC) patients, the probability of treatment with curative intent varies between hospitals and is associated with survival. This study examines the effect of this variation on health economics outcomes and cost-effectiveness. We performed a cost-effectiveness analysis from a societal perspective in potentially curable EC or GC patients selected from the Netherlands Cancer Registry. Resource use and costs were estimated for each treatment strategy from diagnosis until five years follow-up using a top\u2013down costing method. Hospitals were divided into tertiles of low, medium, or high probability of treatment with curative intent using multilevel multivariable logistic regression. The primary outcome was the incremental cost-effectiveness ratio (ICER). Mean total costs per patient was not significantly different between low, medium, and high probability hospitals for EC (n\u2009=\u20099468) (\u20ac47,532 vs. \u20ac47,384 vs. \u20ac47,825), while for GC (n\u2009=\u20093085) costs were significantly lower in low compared to medium and high probability hospitals (\u20ac27,759 vs. \u20ac30,183 vs. \u20ac29,589, both P\u2009&amp;lt;\u20090.001). Costs per quality adjusted life year (QALY) were slightly lower in high probability hospitals for both EC and GC (EC: \u20ac29,181 vs. \u20ac28,646 vs. \u20ac27,659, GC: \u20ac25,003 vs. \u20ac22,505 vs. \u20ac20,495). ICERs were highest for high vs. medium probability hospitals for EC (\u20ac4900\/QALY) and for medium vs. low probability hospitals for GC (\u20ac10,539\/QALY). Variation in treatment with curative intent between hospitals affects health economics outcomes to a limited extent. Although all hospital comparisons were cost-effective, for the highest QALY gain, it is recommended to treat potentially curable patients as in high probability hospitals.<\/jats:p>","DOI":"10.1093\/dote\/doaf057","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T12:28:56Z","timestamp":1752841736000},"source":"Crossref","is-referenced-by-count":1,"title":["A cost-effectiveness analysis of the effect of hospital variation in the probability of providing treatment with curative intent in potentially curable esophageal and gastric cancer patients"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1252-5026","authenticated-orcid":false,"given":"Saskia P M","family":"Truijen","sequence":"first","affiliation":[{"name":"Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL) , Boven Clarenburg 2, 3511 CV, Utrecht ,","place":["the Netherlands"]},{"name":"Department of Rheumatology, Maastricht University Medical Center, and Care and Public Health Institute (CAPHRI), Maastricht University , P. Debyelaan 25, 6229 HX, Maastricht ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline A J","family":"Vissers","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL) , Boven Clarenburg 2, 3511 CV, Utrecht ,","place":["the Netherlands"]},{"name":"Department of Surgery, Radboud University Medical Center , Geert Grooteplein Zuid 10, 6525 GA, Nijmegen ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grard A P","family":"Nieuwenhuijzen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catharina Hospital , Michelangelolaan 2, 5623 EJ, Eindhoven ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurice J C","family":"van der Sangen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Catharina Hospital , Michelangelolaan 2, 5623 EJ, Eindhoven ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter D","family":"Siersema","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center , Geert Grooteplein Zuid 10, 6525 GA, Nijmegen ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marije","family":"Slingerland","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Leiden University Medical Center , Albinusdreef 2, 2333 ZG, Leiden ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia H","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University Medical Center Utrecht , Heidelberglaan 100, 3584 CX, Utrecht ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurens V","family":"Beerepoot","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Elisabeth-TweeSteden Hospital , Dr. Deelenlaan 5, 5042 AD, Tilburg ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8689-3134","authenticated-orcid":false,"given":"Mark I","family":"van Berge Henegouwen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam University Medical Centers, location University of Amsterdam , De Boelelaan 1117, 1081 HV, Amsterdam ,","place":["the Netherlands"]},{"name":"Cancer Center Amsterdam, Cancer Treatment and Quality of Life Amsterdam , De Boelelaan 1118, 1081 HV, Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pieter C","family":"van der Sluis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus Medical Center , Dr. Molewaterplein 40, 3015 GD, Rotterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9152-3987","authenticated-orcid":false,"given":"Camiel","family":"Rosman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Radboud University Medical Center , Geert Grooteplein Zuid 10, 6525 GA, Nijmegen ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewout A","family":"Kouwenhoven","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ziekenhuisgroep (Hospital Group) Twente , Zilvermeeuw 1, 7609 PP, Almelo ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00fcseyin","family":"Akta\u015f","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Ziekenhuisgroep (Hospital Group) Twente , Zilvermeeuw 1, 7609 PP, Almelo ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanneke W M","family":"van Laarhoven","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Cancer Treatment and Quality of Life Amsterdam , De Boelelaan 1118, 1081 HV, Amsterdam ,","place":["the Netherlands"]},{"name":"Department of Medical Oncology, Amsterdam University Medical Center location University of Amsterdam , De Boelelaan 1117, 1081 HV, Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carin A","family":"Uyl-de Groot","sequence":"additional","affiliation":[{"name":"Erasmus School of Health Policy and Management, Erasmus University Rotterdam , Burgemeester Oudlaan 50, 3062 PA, Rotterdam ,","place":["the Netherlands"]},{"name":"Institute for Medical Technology Assessment, Erasmus University Rotterdam , Burgemeester Oudlaan 50, 3062 PA, Rotterdam ,","place":["the 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