'More than just money' - widening the understanding of the costs involved in cancer care

Aim. This paper examines the literature relating to the wider concept of co st in cancer care and the implications this has for the development of serv ices particularly within the changing context of cancer care. Background. Cancer remains a major cause of morbidity and mortality in the United Kingdom (UK), treatment is often complex and expensive; both in fina ncial and human terms. Service patterns for cancer care are shifting away f rom traditional inpatient, hospital settings towards short stay/day-care an d home care models. This is in response to developments in health care poli cy, but it is also because of the availability of better tolerated treatmen ts and demand for more patient-focused health care. Review of the literature. The databases of Cinhahl and Medline were accesse d using the keywords of costs, treatment, outpatients, home care and cancer . Additional sources of literature were also accessed through hand searchin g key journals. The paper explores the literature in three themes. First, t he cost-effectiveness of cancer treatment; second, the often invisible indi rect or 'out of pocket' costs incurred by patients and their families durin g cancer treatment and finally, the 'human costs' of a cancer diagnosis and cancer therapy. Conclusions. In view of recent calls to improve the effectiveness of cancer care in the UK, we suggest that research is needed to address all the dime nsions of cost. It is only by exploring total costs from this broad perspec tive that appropriate, effective and holistic services can be planned for t he future.