Costs of Biopsy and Complications in Patients with Lung Cancer
| Autor: | Dean G. Smith, Richard Culbertson, Yu Wen Chiu, Oliver J. Wagner, Yu Hsiang Kao, Michael Simoff, David Ost, J Lavin |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Percutaneous Adult patients medicine.diagnostic_test diagnosis business.industry Health Policy medicine.medical_treatment Economics Econometrics and Finance (miscellaneous) Cancer economics medicine.disease Surgery ClinicoEconomics and Outcomes Research Pneumothorax frequency Biopsy medicine cancer Intubation In patient business Lung cancer health care economics and organizations Original Research |
| Zdroj: | ClinicoEconomics and Outcomes Research: CEOR |
| ISSN: | 1178-6981 |
| Popis: | Yu-Wen Chiu,1 Yu-Hsiang Kao,1 Michael J Simoff,2 David E Ost,3 Oliver Wagner,4 James Lavin,4 Richard A Culbertson,1 Dean G Smith1 1Health Policy & Systems Management, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA; 2Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan, USA; 3Department of Pulmonology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; 4Intuitive Surgical, Sunnyvale, California, USACorrespondence: Dean G SmithLSU Health Sciences Center – New Orleans, School of Public Health, 2020 Gravier St., New Orleans, LA, 70112, USAEmail dgsmith@lsuhsc.eduPurpose: To describe the distribution of diagnostic procedures, rates of complications, and total cost of biopsies for patients with lung cancer.Patients and Methods: Observational study using data from IBM Marketscan® Databases for continuously insured adult patients with a primary lung cancer diagnosis and treatment between July 2013 and June 2017. Costs of lung cancer diagnosis covered 6 months prior to index biopsy through treatment. Costs of chest CT scans, biopsy, and post-procedural complications were estimated from total payments. Costs of biopsies incidental to inpatient admissions were estimated by comparable outpatient biopsies.Results: The database included 22,870 patients who had a total of 37,160 biopsies, of which 16,009 (43.1%) were percutaneous, 14,997 (40.4%) bronchoscopic, 4072 (11.0%) surgical and 2082 (5.6%) mediastinoscopic. Multiple biopsies were performed on 41.9% of patients. The most common complications among patients receiving only one type of biopsy were pneumothorax (1304 patients, 8.4%), bleeding (744 patients, 4.8%) and intubation (400 patients, 2.6%). However, most complications did not require interventions that would add to costs. Median total costs were highest for inpatient surgical biopsies ($29,988) and lowest for outpatient percutaneous biopsies ($1028). Repeat biopsies of the same type increased costs by 40– 80%. Complications account for 13% of total costs.Conclusion: Costs of biopsies to confirm lung cancer diagnosis vary substantially by type of biopsy and setting. Multiple biopsies, inpatient procedures and complications result in higher costs.Keywords: cancer, diagnosis, economics, frequency |
| Databáze: | OpenAIRE |
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