Emily L Mueller1,2, Matt Hall3, Jay G Berry4, Aaron E Carroll2, Michelle L Macy5,6. 1. Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, Indianapolis, Indiana. 2. Department of Pediatrics, Center for Pediatric and Adolescent Comparative Effectiveness Research, Indiana University, Indianapolis, Indiana. 3. Division of Analytics, Children's Hospital Association, Overland Park, Kansas. 4. Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. 5. Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, Michigan. 6. Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan.
Abstract
BACKGROUND: Children with cancer are a unique patient population with high resource, complex healthcare needs. Understanding their healthcare utilization could highlight areas for care optimization. PROCEDURE: We performed a retrospective, cross-sectional analysis of the 2014 Truven Marketscan Medicaid Database to explore clinical attributes, utilization, and spending among children with cancer who were Medicaid enrollees. Eligible patients included children (ages 0-18 years) with cancer (Clinical Risk Group 8). Healthcare utilization and spending (per member per month, PMPM) were assessed overall and across specific healthcare services. RESULTS: Children with cancer (n = 5,405) represent less than 1% of the 1,516,457 children with medical complexity in the dataset. Children with cancer had high services use: laboratory/radiographic testing (93.0%), outpatient specialty care (83.4%), outpatient therapy/treatment (53.4%), emergency department (43.7%), hospitalization (31.5%), home healthcare (9.5%). PMPM spending for children with cancer was $3,706 overall and $2,323 for hospital care. CONCLUSION: Children with cancer have high healthcare resource use and spending. Differences in geographic distribution of services for children with cancer and the trajectory of spending over the course of therapy are areas for future investigation aimed at lowering costs of care without compromising on health outcomes.
BACKGROUND:Children with cancer are a unique patient population with high resource, complex healthcare needs. Understanding their healthcare utilization could highlight areas for care optimization. PROCEDURE: We performed a retrospective, cross-sectional analysis of the 2014 Truven Marketscan Medicaid Database to explore clinical attributes, utilization, and spending among children with cancer who were Medicaid enrollees. Eligible patients included children (ages 0-18 years) with cancer (Clinical Risk Group 8). Healthcare utilization and spending (per member per month, PMPM) were assessed overall and across specific healthcare services. RESULTS:Children with cancer (n = 5,405) represent less than 1% of the 1,516,457 children with medical complexity in the dataset. Children with cancer had high services use: laboratory/radiographic testing (93.0%), outpatient specialty care (83.4%), outpatient therapy/treatment (53.4%), emergency department (43.7%), hospitalization (31.5%), home healthcare (9.5%). PMPM spending for children with cancer was $3,706 overall and $2,323 for hospital care. CONCLUSION:Children with cancer have high healthcare resource use and spending. Differences in geographic distribution of services for children with cancer and the trajectory of spending over the course of therapy are areas for future investigation aimed at lowering costs of care without compromising on health outcomes.
Authors: Paul C Nathan; Karen E Bremner; Ning Liu; Sumit Gupta; Mark L Greenberg; Mary L McBride; Murray D Krahn; Claire de Oliveira Journal: J Natl Cancer Inst Date: 2019-03-01 Impact factor: 13.506
Authors: Mary L McBride; Claire de Oliveira; Ross Duncan; Karen E Bremner; Ning Liu; Mark L Greenberg; Paul C Nathan; Paul C Rogers; Stuart J Peacock; Murray D Krahn Journal: Healthc Policy Date: 2020-02