Background: Cancer healthcare requires multidisciplinary teams (MDT) in order to prevent, diagnose and treat patients. MDT fragmentation in multiple providers leads to negative outcomes. In Colombia by 2020 breast cancer (BC) and stomach cancer (SC) ranked first in incidence and mortality rate, fragmentation effect in this context has not been assessed. MDT fragmentation effect on BC and SC costs and mortality were calculated.

Methods: Two national retrospective cohorts were conducted from 2013 – 2017 based on administrative data. Patients were selected through ICE-10 codes and oncologic procedures (chemotherapy, radiotherapy and surgery) according to an algorithm. Fragmentation as exposure was calculated by the number of providers adjusted for survival time in years. Primary outcomes were mortality and direct cost. Lineal generalized and Poisson models were used for multivariate analysis on cost and mortality. Statistical analysis was made in STATA 15.

Results: 5367 BC and 1027 SC patients were selected. SC patients were older, the proportion of women is higher in BC. SC mortality is higher than BC (62.8% vs. 17.6%). Median survival in SC patients was 2.2 years, in BC patients was 4.9 years. Fragmentation in healthcare leads to an increase in 27% and 0,01% in mortality by one additional provider adjusted by survival time in BC and SC respectively (BC: RR 1.271 (IC 95% 1.259 – 1.283); SC: RR 1.015 (IC 95% 1.014 – 1.016)). Multivariate analysis on cost shows an increase in $ 3.864.467 COP by one additional provider adjusted by survival time in BC (IC 95% 3.279.512 – 4.449.422) and $ 299.287 COP in SC (IC 95% 60. 488 – 538.086).

Conclusion: Cancer healthcare fragmentation has a real impact in costs and mortality. Evidence shows the need to integrate delivery of healthcare in cancer, providers must include all MTD’s integrants in one provider to decrease cost and mortality.