Associations between healthcare costs and care experiences among older adults with and without cancer.

Autor: Allaire BT; RTI International, Research Triangle Park, NC 27709, USA. Electronic address: ballaire@rti.org., Zabala D; RTI International, Research Triangle Park, NC 27709, USA., Lines LM; RTI International, Research Triangle Park, NC 27709, USA; University of Massachusetts Chan Medical School, Worcester, MA, USA., Williams C; National Cancer Institute, Bethesda, MD, USA., Halpern M; National Cancer Institute, Bethesda, MD, USA., Mollica M; National Cancer Institute, Bethesda, MD, USA.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2023 Sep; Vol. 14 (7), pp. 101561. Date of Electronic Publication: 2023 Jun 29.
DOI: 10.1016/j.jgo.2023.101561
Abstrakt: Introduction: Care coordination and patient-provider communication are important for older adults with cancer, as they likely have additional, non-cancer chronic conditions requiring consultation across multiple providers. Suboptimal care coordination and patient-provider communication can lead to costly and preventable adverse outcomes. This study examines Medicare expenditures associated with patient-reported care coordination and patient-provider communication among older adults with and without cancer.
Materials and Methods: We explore SEER-CAHPS® (Surveillance, Epidemiology and End Results-Consumer Assessment of Healthcare Providers and Systems) linked data for differences in health care expenditures by care coordination and patient-provider communication experiences for beneficiaries with and without cancer. The cancer cohort included beneficiaries with ten prevalent cancer types diagnosed 2011-2019 at least six months before completing a CAHPS survey. Medicare expenditures were abstracted from Medicare claims data. Care coordination and patient-provider communication composite scores (range 0-100, higher scores indicate better experiences) were patient-reported in the CAHPS® survey. We estimated expenditure differences per one-point change in composite scores for patients with and without cancer.
Results: Our analysis included 16,778 matched beneficiaries with and without a previously diagnosed cancer (N = 33,556). Higher care coordination and patient-provider communication scores were inversely associated with Medicare expenditures among beneficiaries with and without cancer in the six months prior to survey response, ranging from -$83 (standard error [SE] = $7) to -$90 (SE = $6) per month. Six months post-survey, expenditures estimates ranging -$88 (SE = $6) to -$106 (SE = $8) were found.
Discussion: We found that lower Medicare expenditures were associated with higher care coordination and patient-provider communication scores. As the number of survivors living longer both with and beyond their cancer grows, addressing their multifaceted care and improving outcomes will be critical.
Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest with this manuscript. The views expressed here are those of the authors and do not represent any official position of the National Cancer Institute or the National Institutes of Health.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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