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Costs of Cancer Care Across the Disease Continuum.

Publication ,  Journal Article
Kaye, DR; Min, HS; Herrel, LA; Dupree, JM; Ellimoottil, C; Miller, DC
Published in: Oncologist
July 2018

PURPOSE: The aim of this study was to estimate Medicare payments for cancer care during the initial, continuing, and end-of-life phases of care for 10 malignancies and to examine variation in expenditures according to patient characteristics and cancer severity. MATERIALS AND METHODS: We used linked Surveillance, Epidemiology and End Results-Medicare data to identify patients aged 66-99 years who were diagnosed with one of the following 10 cancers: prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian, from 2007 through 2012. We attributed payments for each patient to a phase of care (i.e., initial, continuing, or end of life), based on time from diagnosis until death or end of study interval. We summed payments for all claims attributable to the primary cancer diagnosis and analyzed the overall and phase-based costs and then by differing demographics, cancer stage, geographic region, and year of diagnosis. RESULTS: We identified 428,300 patients diagnosed with one of the 10 malignancies. Annual payments were generally highest during the initial phase. Mean expenditures across cancers were $14,381 during the initial phase, $2,471 for continuing, and $13,458 at end of life. Payments decreased with increasing age. Black patients had higher payments for four of five cancers with statistically significant differences. Stage III cancers posed the greatest annual cost burden for four cancer types. Overall payments were stable across geographic region and year. CONCLUSION: Considerable differences exist in expenditures across phases of cancer care. By understanding the drivers of such payment variations across patient and tumor characteristics, we can inform efforts to decrease payments and increase quality, thereby reducing the burden of cancer care. IMPLICATIONS FOR PRACTICE: Considerable differences exist in expenditures across phases of cancer care. There are further differences by varying patient characteristics. Understanding the drivers of such payment variations across patient and tumor characteristics can inform efforts to decrease costs and increase quality, thereby reducing the burden of cancer care.

Duke Scholars

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Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

July 2018

Volume

23

Issue

7

Start / End Page

798 / 805

Location

England

Related Subject Headings

  • United States
  • Terminal Care
  • SEER Program
  • Oncology & Carcinogenesis
  • Neoplasms
  • Medicare
  • Male
  • Humans
  • Health Care Costs
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kaye, D. R., Min, H. S., Herrel, L. A., Dupree, J. M., Ellimoottil, C., & Miller, D. C. (2018). Costs of Cancer Care Across the Disease Continuum. Oncologist, 23(7), 798–805. https://doi.org/10.1634/theoncologist.2017-0481
Kaye, Deborah R., Hye Sung Min, Lindsey A. Herrel, James M. Dupree, Chad Ellimoottil, and David C. Miller. “Costs of Cancer Care Across the Disease Continuum.Oncologist 23, no. 7 (July 2018): 798–805. https://doi.org/10.1634/theoncologist.2017-0481.
Kaye DR, Min HS, Herrel LA, Dupree JM, Ellimoottil C, Miller DC. Costs of Cancer Care Across the Disease Continuum. Oncologist. 2018 Jul;23(7):798–805.
Kaye, Deborah R., et al. “Costs of Cancer Care Across the Disease Continuum.Oncologist, vol. 23, no. 7, July 2018, pp. 798–805. Pubmed, doi:10.1634/theoncologist.2017-0481.
Kaye DR, Min HS, Herrel LA, Dupree JM, Ellimoottil C, Miller DC. Costs of Cancer Care Across the Disease Continuum. Oncologist. 2018 Jul;23(7):798–805.

Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

July 2018

Volume

23

Issue

7

Start / End Page

798 / 805

Location

England

Related Subject Headings

  • United States
  • Terminal Care
  • SEER Program
  • Oncology & Carcinogenesis
  • Neoplasms
  • Medicare
  • Male
  • Humans
  • Health Care Costs
  • Female