Bhattacharjee Sandipan, Gharaibeh Mahdi, Kamal Muhammad Umar, Riaz Irbaz Bin
Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ.
Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ.
Clin Genitourin Cancer. 2017 Jun;15(3):e357-e368. doi: 10.1016/j.clgc.2016.12.017. Epub 2016 Dec 29.
Health and functional status, as well as co-occurring chronic conditions, have a profound influence on healthcare expenditures. However, no study to date has assessed their influence among community-dwelling adults with kidney cancer (KC) in the United States (US). This study assessed the impact of health and functional status, along with co-occurring chronic conditions, on KC healthcare expenditures.
This study used a retrospective, cross-sectional, propensity-score-matched, case-control study design using 2002 to 2011 Medical Expenditure Panel Survey data. The case group was comprised of adults with KC, whereas the control group consisted of propensity-score matched adults with other forms of cancer. To examine the impact of health and functional status and co-occurring chronic conditions, ordinary least square regressions on log-transformed expenditures were conducted on total and subtypes of healthcare expenditures. The percentage change in expenditure was calculated using the formula (exp - 1).
Findings from this study indicate that the annual average total healthcare expenditures ($15,078 vs. $8182; P < .001) for adults with KC were significantly higher compared with propensity-score-matched adults with other forms of cancer. Total healthcare expenditures for adults with KC were 80% (β = 0.588; P < .001) higher compared with propensity-score-matched controls when only demographic characteristics were adjusted. After adjusting for health and functional status and co-occurring chronic conditions, the percentage decreased from 80% to 43% (β = 0.359; P < .01).
Findings from this nationally representative sample suggest that health and functional status and co-occurring chronic conditions have a significant impact on healthcare expenditures among community-dwelling adults with KC in the US.
健康与功能状况以及并存的慢性病对医疗保健支出有着深远影响。然而，迄今为止尚无研究评估它们在美国社区居住的肾癌（KC）成年患者中的影响。本研究评估了健康与功能状况以及并存的慢性病对KC医疗保健支出的影响。
本研究采用回顾性、横断面、倾向得分匹配的病例对照研究设计，使用2002年至2011年医疗支出面板调查数据。病例组由患有KC的成年人组成，而对照组由倾向得分匹配的患有其他癌症形式的成年人组成。为了检验健康与功能状况以及并存的慢性病的影响，对医疗保健支出的总和亚型进行了对数转换支出的普通最小二乘回归。支出的百分比变化使用公式（exp - 1）计算。
本研究结果表明，与倾向得分匹配的患有其他癌症形式的成年人相比，患有KC的成年人的年度平均总医疗保健支出（15,078美元对8182美元；P <.001）显著更高。仅调整人口统计学特征时，患有KC的成年人的总医疗保健支出比倾向得分匹配的对照组高80%（β = 0.588；P <.001）。在调整健康与功能状况以及并存的慢性病后，百分比从80%降至43%（β = 0.359；P <.01）。
来自这个具有全国代表性样本的结果表明，健康与功能状况以及并存的慢性病对美国社区居住的KC成年患者的医疗保健支出有重大影响。
