Tiffany J Sierro1, Laura Y Blumenthal2, Joshua Hekmatjah1, Vipawee S Chat1, Ari A Kassardjian1, Charlotte Read3, April W Armstrong4. 1. University of Southern California Keck School of Medicine, Los Angeles, California. 2. Center for Dermatology Care, Thousand Oaks, California. 3. University of Southern California Keck School of Medicine, Los Angeles, California; Department of Medicine, Imperial College London, London, United Kingdom. 4. University of Southern California Keck School of Medicine, Los Angeles, California. Electronic address: armstrongpublication@gmail.com.
Abstract
BACKGROUND: As the United States becomes more diverse, determining differences in health care utilization and costs in the management of skin cancers is fundamental to decision-making in health care resource allocation and improving care for underserved populations. OBJECTIVE: To compare health care use and costs among non-Hispanic White, Hispanic White, and non-Hispanic Black patients with keratinocyte carcinoma. METHODS: A nationwide cross-sectional study was performed using Medical Expenditure Panel Survey data from 1996 to 2015. RESULTS: Among 54,503,447 patients with keratinocyte carcinoma (weighted) over a 20-year period, 53,134,351 (97%) were non-Hispanic White; 836,030 (1.5%) were Hispanic White; and 170,755 (0.3%) were non-Hispanic Black. Compared to non-Hispanic White patients, Hispanic White patients had significantly more ambulatory visits per person per year (5.4 vs 3.5, P = .003). Compared to non-Hispanic White patients, non-Hispanic Black patients had significantly more ambulatory visits (13.1 vs 3.5, P = .027) and emergency department visits (2.3 vs 1.1, P < .001), and incurred significantly higher ambulatory costs ($5089 vs $1131, P = .05), medication costs ($523 vs $221, P = .022), and total costs per person per year ($13,430 vs $1290, P = .032). LIMITATIONS: Data for squamous cell carcinomas and basal cell carcinomas are combined. CONCLUSIONS: Keratinocyte carcinoma was more costly to treat and required more health care resources in non-Hispanic Black and Hispanic White patients than in non-Hispanic White patients.
BACKGROUND: As the United States becomes more diverse, determining differences in health care utilization and costs in the management of skin cancers is fundamental to decision-making in health care resource allocation and improving care for underserved populations. OBJECTIVE: To compare health care use and costs among non-Hispanic White, Hispanic White, and non-Hispanic Black patients with keratinocyte carcinoma. METHODS: A nationwide cross-sectional study was performed using Medical Expenditure Panel Survey data from 1996 to 2015. RESULTS: Among 54,503,447 patients with keratinocyte carcinoma (weighted) over a 20-year period, 53,134,351 (97%) were non-Hispanic White; 836,030 (1.5%) were Hispanic White; and 170,755 (0.3%) were non-Hispanic Black. Compared to non-Hispanic White patients, Hispanic White patients had significantly more ambulatory visits per person per year (5.4 vs 3.5, P = .003). Compared to non-Hispanic White patients, non-Hispanic Black patients had significantly more ambulatory visits (13.1 vs 3.5, P = .027) and emergency department visits (2.3 vs 1.1, P < .001), and incurred significantly higher ambulatory costs ($5089 vs $1131, P = .05), medication costs ($523 vs $221, P = .022), and total costs per person per year ($13,430 vs $1290, P = .032). LIMITATIONS: Data for squamous cell carcinomas and basal cell carcinomas are combined. CONCLUSIONS: Keratinocyte carcinoma was more costly to treat and required more health care resources in non-Hispanic Black and Hispanic White patients than in non-Hispanic White patients.
Keywords:
BCC; KC; NMSC; SCC; basal cell carcinoma; ethnicity; health care cost; health care resource use; health care utilization; keratinocyte carcinoma; minorities; non-melanoma skin cancer; race; skin of color; squamous cell carcinoma
Authors: Roxana Daneshjou; Kailas Vodrahalli; Roberto A Novoa; Melissa Jenkins; Weixin Liang; Veronica Rotemberg; Justin Ko; Susan M Swetter; Elizabeth E Bailey; Olivier Gevaert; Pritam Mukherjee; Michelle Phung; Kiana Yekrang; Bradley Fong; Rachna Sahasrabudhe; Johan A C Allerup; Utako Okata-Karigane; James Zou; Albert S Chiou Journal: Sci Adv Date: 2022-08-12 Impact factor: 14.957