Your browser doesn't support javascript.
loading
Healthcare utilization and costs associated with COPD among SEER-Medicare beneficiaries with NSCLC.
Shah, Shweta; Blanchette, Christopher M; Coyle, Joseph C; Kowalkowski, Marc; Arthur, Susan T; Howden, Reuben.
Afiliação
  • Shah S; a Department of Public Health Sciences , University of North Carolina at Charlotte , NC , USA.
  • Blanchette CM; a Department of Public Health Sciences , University of North Carolina at Charlotte , NC , USA.
  • Coyle JC; b Department of Kinesiology , University of North Carolina at Charlotte , NC , USA.
  • Kowalkowski M; c Levine Cancer Institute, Carolinas Healthcare System , Charlotte , NC , USA.
  • Arthur ST; b Department of Kinesiology , University of North Carolina at Charlotte , NC , USA.
  • Howden R; a Department of Public Health Sciences , University of North Carolina at Charlotte , NC , USA.
J Med Econ ; 21(9): 861-868, 2018 Sep.
Article em En | MEDLINE | ID: mdl-29857784
ABSTRACT

AIM:

To estimate the healthcare utilization and costs in elderly lung cancer patients with and without pre-existing chronic obstructive pulmonary disease (COPD).

METHODS:

Using Surveillance, Epidemiology and End Results (SEER)-Medicare data, this study identified patients with lung cancer between 2006-2010, at least 66 years of age, and continuously enrolled in Medicare Parts A and B in the 12 months prior to cancer diagnosis. The diagnosis of pre-existing COPD in lung cancer patients was identified using ICD-9 codes. Healthcare utilization and costs were categorized as inpatient hospitalizations, skilled nursing facility (SNF) use, physician office visits, ER visits, and outpatient encounters for every stage of lung cancer. The adjusted analysis was performed using a generalized linear model for healthcare costs and a negative binomial model for healthcare utilization.

RESULTS:

Inpatient admissions in the COPD group increased for each stage of non-small cell lung cancer (NSCLC) compared to the non-COPD group per 100 person-months (Stage I 14.67 vs 9.49 stays, p < .0001; Stage II 14.13 vs 10.78 stays, p < .0001; Stage III 28.31 vs 18.91 stays, p < .0001; Stage IV 49.5 vs 31.24 stays, p < .0001). A similar trend was observed for outpatient visits, with an increase in utilization among the COPD group (Stage I 1136.04 vs 796 visits, p < .0001; Stage II 1325.12 vs 983.26 visits, p < .0001; Stage III 2025.47 vs 1656.64 visits, p < .0001; Stage IV 2825.73 vs 2422.26 visits, p < .0001). Total direct costs per person-month in patients with pre-existing COPD were significantly higher than the non-COPD group across all services ($54,799.16 vs $41,862.91). Outpatient visits represented the largest cost category across all services in both groups, with higher costs among the COPD group ($41,203 vs $31,140.08).

CONCLUSION:

Healthcare utilization and costs among lung cancer patients with pre-existing COPD was ∼2-3-times higher than the non-COPD group.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Medicare / Carcinoma Pulmonar de Células não Pequenas / Doença Pulmonar Obstrutiva Crônica / Serviços de Saúde / Neoplasias Pulmonares Tipo de estudo: Health_economic_evaluation / Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País como assunto: America do norte Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Medicare / Carcinoma Pulmonar de Células não Pequenas / Doença Pulmonar Obstrutiva Crônica / Serviços de Saúde / Neoplasias Pulmonares Tipo de estudo: Health_economic_evaluation / Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged País como assunto: America do norte Idioma: En Ano de publicação: 2018 Tipo de documento: Article