Cancer Prevention and Control Program, Georgetown University Medical Center, Washington, DC 20007, USA.
J Med Econ. 2012;15(4):688-94. doi: 10.3111/13696998.2012.673524. Epub 2012 Mar 21.
To evaluate breast cancer-associated healthcare cost from the payer perspective for the initial year after diagnoses of invasive breast cancer.
Breast cancer is the second most common malignancy in American women. While lifetime burden-of-care studies have reported spending between $20,000 and $100,000 per patient, previous studies have not outlined first year cost in managing this disease in recently diagnosed patients.
This study was a retrospective, matched cohort study of privately-insured patients. Data were from a large US employers' health claims database (January 2003-September 2008). Breast cancer cases were identified by ICD-9-CM diagnostic codes on index and confirmatory claims. A control group was identified with a ratio of 3:1, matched by demographic and health plan characteristics. Comorbidities were analyzed using the Charlson comorbidity index and AHRQ Comorbidity Software. A multivariate, log-linked, generalized linear model evaluated cost contributions of breast cancer in relation to demographic factors, comorbidities, and plan type.
The study included 35,057 cases and 105,171 matched controls (mean age 52 years). Common comorbidities included hypertension, diabetes, hypothyroidism, chronic pulmonary disease, and deficiency anemia. In the generalized linear model, the adjusted difference in total healthcare cost was $42,401 per patient within a year, with outpatient services responsible for most of this sum. Breast cancer-associated incremental annual costs per patient in inpatient, outpatient, and prescription categories were $5100, $37,231, and $1037, respectively.
These results may not be representative of the entire US, as data were derived from breast cancer patients with private, employer-based health insurance, and lacked covariates including race/ethnicity, education, income, and disease stage.
Recently diagnosed breast cancer represents a substantial economic burden for US healthcare payers.
从支付者的角度评估浸润性乳腺癌诊断后第一年的乳腺癌相关医疗保健费用。
乳腺癌是美国女性中第二常见的恶性肿瘤。虽然终生负担研究报告每位患者的支出在 20,000 美元至 100,000 美元之间，但以前的研究并未详细说明在最近诊断出患有这种疾病的患者中管理该病的第一年的费用。
这是一项回顾性、匹配队列研究，涉及私人保险患者。数据来自美国一家大型雇主健康保险索赔数据库（2003 年 1 月至 2008 年 9 月）。通过索引和确认索赔中的 ICD-9-CM 诊断代码确定乳腺癌病例。通过人口统计学和健康计划特征的比例为 3:1 确定对照组。使用 Charlson 合并症指数和 AHRQ 合并症软件分析合并症。使用多元对数链接广义线性模型评估乳腺癌在与人口统计学因素、合并症和计划类型相关的成本贡献。
该研究包括 35057 例病例和 105171 例匹配对照组（平均年龄 52 岁）。常见的合并症包括高血压、糖尿病、甲状腺功能减退、慢性肺部疾病和缺铁性贫血。在广义线性模型中，一年内每位患者的总医疗保健费用调整差异为 42401 美元，其中大部分来自门诊服务。乳腺癌相关的每位患者的增量年度费用分别为住院、门诊和处方类别中的 5100 美元、37231 美元和 1037 美元。
这些结果可能不能代表整个美国，因为数据来自具有私人雇主健康保险的乳腺癌患者，并且缺乏种族/民族、教育、收入和疾病阶段等协变量。
最近诊断出的乳腺癌对美国医疗保健支付者来说是一个巨大的经济负担。
