Cost drivers of locally advanced rectal cancer treatment-An analysis of a leading healthcare insurer
Autor: | Amit Merchea, Nitin Mishra, Fabian Grass, Lindsey R. Sangaralingham, David W. Larson, Herbert C. Heien, Kellie L. Mathis |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent Colorectal cancer medicine.medical_treatment Insurance Carriers Medicare Advantage Medicare 03 medical and health sciences Young Adult 0302 clinical medicine Ambulatory care Cost of Illness Health care medicine Humans Robotic surgery Aged Retrospective Studies Aged 80 and over Chemotherapy Insurance Health Proctectomy business.industry Rectal Neoplasms General surgery Combined Modality Therapy Female Follow-Up Studies Health Care Costs/statistics & numerical data Insurance Carriers/statistics & numerical data Medicare/statistics & numerical data Middle Aged Neoadjuvant Therapy/economics Proctectomy/economics Prognosis Rectal Neoplasms/economics Rectal Neoplasms/epidemiology Rectal Neoplasms/therapy Survival Rate United States/epidemiology cost multidisciplinary rectal cancer treatment General Medicine Health Care Costs medicine.disease Neoadjuvant Therapy United States Radiation therapy Oncology Cost driver 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery business |
Zdroj: | Journal of surgical oncology, vol. 123, no. 4, pp. 1023-1029 |
Popis: | Background To evaluate the economic burden of locally advanced rectal cancer (LARC) treatment from a society perspective through analysis of health insurance-derived data of commercially insured and Medicare Advantage (MA) patients. Methods Retrospective cost analysis of patients undergoing rectal resection within a multimodal (neoadjuvant chemoradiation + adjuvant chemotherapy) treatment strategy between January 1, 2010 and October 31, 2018, using the claims OptumLabs Data Warehouse database. Results In total, 1738 (935 commercial and 803 MA) patients were included. Overall treatment costs totaled $230,881,746 (on average $183 653 ± 82 384 per commercially insured and $73 681 ± 32 917 per MA patient). Cost distribution according to category (commercially insured patients) was: 29.92% related to outpatient care (follow-up visits/diagnostics), radiotherapy: 21.83%, index resection: 20.62%, chemotherapy: 17.44%, surgical inpatient: 6.32%, medical inpatient: 3.28%, emergency room: 0.58%. Relative cost distribution of the index resection itself differed marginally between the three approaches and was 21.49% for open, 19.30% for laparoscopic, and 20.93% for robotic surgery. Relative cost distributions of neoadjuvant, adjuvant, and outpatient treatments remained unchanged, independently of the surgical approach. This representation was similar in MA patients. Conclusion Index-surgery related costs were outweighed by costs related to oncological and outpatient workup/follow-up treatments independently of both surgical approach and insurance type. |
Databáze: | OpenAIRE |
Externí odkaz: |