Longitudinal patterns of cost and utilization of medicare beneficiaries with bladder cancer.
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2020-02
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Abstract
Background
Bladder cancer (BC) is highly prevalent and costly. This study documented cost and use of services for BC care and for other (non-BC) care received over a 15-year follow-up period by a cohort of Medicare beneficiaries diagnosed with BC in 1998.Methods
Data came from the Surveillance, Epidemiology and End Results Program linked to Medicare claims. Medicare claims provided data on diagnoses, services provided, and Medicare Parts A and B payments. Cost was actual Medicare payments to providers inflated to 2018 US$. Cost and utilization were BC-related if the claim contained a BC diagnosis code. Otherwise, costs were for "other care." For utilization, we grouped Part B-covered services into 6 mutually-exclusive categories. Utilization rates were ratios of the count of claims in a particular category during a follow-up year divided by the number of beneficiaries with BC surviving to year-end.Results
Cumulatively over 15-years, for all stages combined, total BC-related cost per BC beneficiary was $42,011 (95% Confidence Interval (CI): $42,405-$43,417); other care cost was about twice this number. Cumulative total BC-related cost of 15-year BC survivors for all stages was $43,770 (CI: $39,068-$48,522), intensity of BC-related care was highest during the first year following BC diagnosis, falling substantially thereafter. After follow-up year 5, there were few statistically significant changes in BC-related utilization. Utilization of other care remained constant during follow-up or increased.Conclusions
Substantial costs were incurred for non-BC care. While increasing BC survivorship is an important objective, non-BC care would remain a burden to Medicare.Type
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Sloan, Frank A, Arseniy P Yashkin, Igor Akushevich and Brant A Inman (2020). Longitudinal patterns of cost and utilization of medicare beneficiaries with bladder cancer. Urologic oncology, 38(2). pp. 39.e11–39.e19. 10.1016/j.urolonc.2019.10.016 Retrieved from https://hdl.handle.net/10161/24269.
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Arseniy Yashkin
I am primarily a health outcomes researcher who specializes in cancers and chronic age-related diseases, especially Alzheimer’s disease and type II diabetes mellitus. However, I also write in epidemiology, demography, health economics and genetics. I am a specialist in the analysis of administrative big health data. My main contributions to scholarship can be summarized across three focus areas: health outcomes research, epidemiology and methodology, and health economics. Some of my most important findings are described below.
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