Kevin D Frick1, Claire F Snyder2, Robert J Herbert2, Amanda L Blackford2, Bridget A Neville2, Antonio C Wolff2, Michael A Carducci2, Craig C Earle2. 1. Johns Hopkins University Carey Business School; Johns Hopkins University School of Medicine; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada kfrick@jhu.edu. 2. Johns Hopkins University Carey Business School; Johns Hopkins University School of Medicine; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Abstract
PURPOSE: To estimate the association between cancer survivors' comorbid condition care quality and costs; to determine whether the association differs between cancer survivors and other patients. METHODS: Using the SEER-Medicare-linked database, we identified survivors of breast, prostate, and colorectal cancers who were diagnosed in 2004, enrolled in Medicare fee-for-service for at least 12 months before diagnosis, and survived ≥ 3 years. Quality of care was assessed using nine process indicators for chronic conditions, and a composite indicator representing seven avoidable outcomes. Total costs on the basis of Medicare amount paid were grouped as inpatient and outpatient. We examined the association between care quality and costs for cancer survivors, and compared this association among 2:1 frequency-matched noncancer controls, using comparisons of means and generalized linear regressions. RESULTS: Our sample included 8,661 cancer survivors and 17,332 matched noncancer controls. Receipt of recommended care was associated with higher outpatient costs for eight indicators, and higher inpatient and total costs for five indicators. For three measures (visit every 6 months for patients with chronic obstructive pulmonary disease or diabetes, and glycosylated hemoglobin or fructosamine every 6 months for patients with diabetes), costs for cancer survivors who received recommended care increased less than for noncancer controls. The absence of avoidable events was associated with lower costs of each type. An annual eye examination for patients with diabetes was associated with lower inpatient costs. CONCLUSION: Higher-quality processes of care may not reduce short-term costs, but the prevention of avoidable outcomes reduces costs. The association between quality and cost was similar for cancer survivors and noncancer controls.
PURPOSE: To estimate the association between cancer survivors' comorbid condition care quality and costs; to determine whether the association differs between cancer survivors and other patients. METHODS: Using the SEER-Medicare-linked database, we identified survivors of breast, prostate, and colorectal cancers who were diagnosed in 2004, enrolled in Medicare fee-for-service for at least 12 months before diagnosis, and survived ≥ 3 years. Quality of care was assessed using nine process indicators for chronic conditions, and a composite indicator representing seven avoidable outcomes. Total costs on the basis of Medicare amount paid were grouped as inpatient and outpatient. We examined the association between care quality and costs for cancer survivors, and compared this association among 2:1 frequency-matched noncancer controls, using comparisons of means and generalized linear regressions. RESULTS: Our sample included 8,661 cancer survivors and 17,332 matched noncancer controls. Receipt of recommended care was associated with higher outpatient costs for eight indicators, and higher inpatient and total costs for five indicators. For three measures (visit every 6 months for patients with chronic obstructive pulmonary disease or diabetes, and glycosylated hemoglobin or fructosamine every 6 months for patients with diabetes), costs for cancer survivors who received recommended care increased less than for noncancer controls. The absence of avoidable events was associated with lower costs of each type. An annual eye examination for patients with diabetes was associated with lower inpatient costs. CONCLUSION: Higher-quality processes of care may not reduce short-term costs, but the prevention of avoidable outcomes reduces costs. The association between quality and cost was similar for cancer survivors and noncancer controls.
Authors: Claire F Snyder; Kevin D Frick; Robert J Herbert; Amanda L Blackford; Bridget A Neville; Klaus W Lemke; Michael A Carducci; Antonio C Wolff; Craig C Earle Journal: J Cancer Surviv Date: 2015-02-26 Impact factor: 4.442
Authors: Claire F Snyder; Kevin D Frick; Robert J Herbert; Amanda L Blackford; Bridget A Neville; Antonio C Wolff; Michael A Carducci; Craig C Earle Journal: J Clin Oncol Date: 2013-02-11 Impact factor: 44.544
Authors: N Lynn Henry; Lynn N Henry; Daniel F Hayes; Scott D Ramsey; Gabriel N Hortobagyi; William E Barlow; Julie R Gralow Journal: J Natl Cancer Inst Date: 2014-03-13 Impact factor: 13.506
Authors: Brian Seal; Sean D Sullivan; Scott D Ramsey; Carl V Asche; Ken Shermock; Syam Sarma; Erin A Zagadailov; Eileen Farrelly; Michael Eaddy Journal: Appl Health Econ Health Policy Date: 2014-10 Impact factor: 2.561