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Background Communication with health care providers during diagnosis and treatment planning is of special

Introduction Given the high occurrence and morbidity of non-melanoma skin cancer (nmsc), its economic burden on the Canadian health care system is a cause for concern. Despite that relevance, few studies have used patient-level data to calculate the cost of nmsc. The objective of the present study was to use physician billing data to describe the health care costs and service utilization associated with nmsc in Saskatchewan.Methods The Saskatchewan Cancer Agency’s cancer registry was used to identify patients diagnosed with nmsc between 2004 and 2008. Treatment services and costs were based on physician billing claims, which detail physician services performed in an outpatient setting. Total and annual outpatient costs for nmsc and mean outpatient cost per person were calculated by skin cell type, lesion site, and geographic location. Service utilization and costs by physician specialty were also explored.Results Total outpatient costs grew 12.08% annually, to $845,954.98 in 2008 from $527,458.76 in 2004. The mean outpatient cost per person was estimated at $397.86. Differences in the cost-per-person estimates were observed when results were stratified by skin cell type ($403.41 for basal cell carcinoma vs. $377.85 for squamous cell carcinoma), lesion site ($425.27 for the face vs. $317.80 for an upper limb), and geographic location ($415.07 urban vs. $363.48 rural). Investigation of service utilization found that 92.14% of treatment was delivered by general practice and plastic surgery/otolaryngology physicians; dermatology delivered only 6.33% of services.Conclusions Our results underestimate the direct costs of nmsc because inpatient services and non-physician costs were not included in the calculations. The present research represents a first step in understanding the cost burden of nmsc in Saskatchewan.

BackgroundCancer research is essential in evaluating the safety and effectiveness of emerging cancer treatments, which in turn can lead to ground-breaking advancements in cancer care. Given limited research funding, allocating resources in alignment with societal burden is essential. However, evidence shows that such alignment does not typically occur. The objective of the present study was to provide an updated overview of site-specific cancer research investment in Canada and to explore potential discrepancies between the site-specific burden and the level of research investment.MethodsThe 10 cancer sites with the highest mortality in 2015—which included brain, female breast, colorectal, leukemia, lung, non-Hodgkin lymphoma, ovary, pancreas, prostate, and uterus—were selected for the analysis. Information about site-specific research investment and cancer burden (raw incidence and mortality) was obtained from the Canadian Cancer Research Survey and Statistics Canada’s cansim (the Canadian Socio-Economic Information Management System) respectively. The ratio of site-specific research investment to site-specific burden was used as an indicator of overfunding (ratio > 1) or underfunding (ratio < 1).ResultsThe 3 cancer sites with the highest research investments were leukemia, prostate, and breast, which together represented 51.3% of 2015 cancer research funding. Conversely, the 3 cancer sites with the lowest investments were uterus, pancreas, and ovary, which together represented 7.8% of 2015 research funding. Relative to site-specific cancer burden, the lung, uterus, and colorectal sites were consistently the most underfunded.ConclusionsObserved discrepancies between cancer burden and research investment indicate that some cancer sites (such as lung, colorectal, and uterus) seem to be underfunded when site-specific incidence and mortality are taken into consideration.

CMAJ OPEN, 4(1) E95D iabetic retinopathy is a sight-threatening complication in patients with diabetes mellitus that is usually asymptomatic in the early stages. 1 Effective treatment exists, with over 50% of patients experiencing reduction of severe vision loss if they receive treatment after timely diagnosis. 2About 50% of patients with diabetes do not receive eye examinations as recommended by the American Academy of Ophthalmology.3 This results in lost opportunities to prevent severe vision loss by means of timely treatment delivery. 4 In addition to nonmodifiable factors, limited availability of eye care specialists, travelling difficulties and time constraints also contribute to nonadherence, especially in nonurban areas. 5,6 Pharmacy-based teleophthalmology has emerged as a possible alternative to in-person examinations that may facilitate compliance with evidence-based recommendations and reduce barriers to specialized eye care. 7,8 In a pharmacy-based teleophthalmology program, retinal digital images are captured in a local pharmacy and are securely transmitted electronically to a specialized reading centre, where photographs are graded by an eye specialist.9 Patients with signs of diabetic retinopathy can then be referred to an eye care professional Background: Diabetic eye complications are the leading cause of visual loss among working-aged people. Pharmacy-based teleophthalmology has emerged as a possible alternative to in-person examination that may facilitate compliance with evidence-based recommendations and reduce barriers to specialized eye care. The objective of this study was to estimate the cost-effectiveness of mobile teleophthalmology screening compared with in-person examination (primary care) for the diabetic population residing in semiurban areas of southwestern Ontario.