TY - JOUR
T1 - Healthcare utilization and costs during the initial phase of care among elderly women with breast cancer
AU - Vyas, Ami
AU - Madhavan, S. Suresh
AU - Sambamoorthi, Usha
AU - Pan, Xiaoyun
AU - Regier, Michael
AU - Hazard, Hannah
AU - Kalidindi, Sita
N1 - Funding Information:
From the aDepartment of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island; bDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia; cSunovion Pharmaceuticals, Marlborough, Massachusetts; dDepartment of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia; and eDepartment of Surgery, School of Medicine, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, West Virginia. Submitted February 24, 2017; accepted for publication June 6, 2017. The authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. This study was part of Dr. Vyas’ doctoral dissertation at West Virginia University and was supported by an AHRQ grant (R24HS018622-03). Some additional salary support was received by Drs. Madhavan and Sambamoorthi from a National Institute of General Medicine Sciences
Publisher Copyright:
© JNCCN - Journal of the National Comprehensive Cancer Network.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background: Understanding the patterns of healthcare utilization and costs during the initial phase of care (12 months after breast cancer [BC] diagnosis) in older women (aged ≥65 years) is crucial in the allocation of Medicare resources. The objective of this study was to determine healthcare utilization and costs during the initial phase of care in older, female, Medicare fee-for-service benefiiciaries diagnosed with BC, and to determine the factors associated with higher costs. Methods: A retrospective observational study using the SEER-Medicare linked database was conducted in 69,307 women aged ≥66 years diagnosed with primary incident BC in 2003-2009 to determine healthcare utilization, average costs, and costs for specific services during the initial phase of care. Generalized linear model regression was conducted to identify the factors associated with higher costs in a multivariate framework. Results: A total of 96% of women were treated with surgery during the initial phase of BC care, whereas 21% and 54% underwent chemotherapy and radiotherapy, respectively. Costs during the initial phase of care totalled $28,075 in 2012 USD, comprising $13,344 for physician services and $7,456 for outpatient services. Factors associated with higher costs during the initial phase of care were younger age (66-69 years), African American race, higher household income, advanced stages of BC, initial BC treatment, higher number of primary care physician visits, and presence of comorbidities and/or a mental condition. Conclusions: The economic burden of BC is substantial during the initial phase of care. Physician and outpatient services accounted for the highest proportion of costs. Predisposing factors, need-related factors, healthcare use, and external environmental healthcare factors significantly predicted costs during the initial phase of care.
AB - Background: Understanding the patterns of healthcare utilization and costs during the initial phase of care (12 months after breast cancer [BC] diagnosis) in older women (aged ≥65 years) is crucial in the allocation of Medicare resources. The objective of this study was to determine healthcare utilization and costs during the initial phase of care in older, female, Medicare fee-for-service benefiiciaries diagnosed with BC, and to determine the factors associated with higher costs. Methods: A retrospective observational study using the SEER-Medicare linked database was conducted in 69,307 women aged ≥66 years diagnosed with primary incident BC in 2003-2009 to determine healthcare utilization, average costs, and costs for specific services during the initial phase of care. Generalized linear model regression was conducted to identify the factors associated with higher costs in a multivariate framework. Results: A total of 96% of women were treated with surgery during the initial phase of BC care, whereas 21% and 54% underwent chemotherapy and radiotherapy, respectively. Costs during the initial phase of care totalled $28,075 in 2012 USD, comprising $13,344 for physician services and $7,456 for outpatient services. Factors associated with higher costs during the initial phase of care were younger age (66-69 years), African American race, higher household income, advanced stages of BC, initial BC treatment, higher number of primary care physician visits, and presence of comorbidities and/or a mental condition. Conclusions: The economic burden of BC is substantial during the initial phase of care. Physician and outpatient services accounted for the highest proportion of costs. Predisposing factors, need-related factors, healthcare use, and external environmental healthcare factors significantly predicted costs during the initial phase of care.
UR - http://www.scopus.com/inward/record.url?scp=85033802388&partnerID=8YFLogxK
U2 - 10.6004/jnccn.2017.0167
DO - 10.6004/jnccn.2017.0167
M3 - Article
C2 - 29118232
AN - SCOPUS:85033802388
SN - 1540-1405
VL - 15
SP - 1401
EP - 1409
JO - JNCCN Journal of the National Comprehensive Cancer Network
JF - JNCCN Journal of the National Comprehensive Cancer Network
IS - 11
ER -