Miami Cancer Institute, Baptist Health South Florida.
Department of Nutrition & Dietetics, University of Central Missouri, Warrensburg, MO.
Am J Clin Oncol. 2020 May;43(5):349-355. doi: 10.1097/COC.0000000000000670.
The objective of this study was to understand recent trends in direct health care expenditures among cancer survivors using novel cost-estimation methods and a nationally representative database.
This study was a retrospective analysis of 193,003 adults, ≥18 years of age, using the Medical Expenditure Panel Survey during the years 2009-2016. Manning and Mullahy two-part model was used to calculate adjusted mean and incremental medical expenditures after adjusting for covariates.
The mean direct annual health care expenditure among cancer survivors ($13,025.0 [$12,572.0 to $13,478.0]) was nearly 3 times greater than noncancer participants ($4689.3 [$4589.2 to $4789.3]) and were mainly spent on inpatient services, office-based visits, and prescription medications. Cancer survivors had an additional health care expenditure of $4407.6 ($3877.6, $4937.6) per person per year, compared with noncancer participants after adjusting for covariates (P<0.001). The total mean annual direct health care expenditure for cancer survivors increased from $12,960.0 (95% confidence interval: $12,291.0-$13,628.0) in 2009-2010 to $13,807.0 ($12,828.0 to $14,787.0) in 2015-2016.
Given the higher health care expenditures among cancer survivors and the increasing prevalence of cancers, cost-saving measures should be planned through multidisciplinary initiatives, collaborative research, and importantly, health care planning and policy changes. Our findings could be helpful in streamlining health care resources and interventions, developing national health care coverage policies, and possibly considering radically new insurance strategies for cancer survivors.
本研究旨在使用新型成本估算方法和全国代表性数据库，了解癌症幸存者直接医疗支出的最新趋势。
这是一项对 193031 名成年人的回顾性分析，年龄≥18 岁，使用 2009-2016 年期间的医疗支出面板调查数据。使用曼宁和毛拉希两部分模型，在调整协变量后计算调整后的平均和增量医疗支出。
癌症幸存者的直接年度医疗保健支出平均为 13025.0 美元（12572.0 美元至 13478.0 美元），几乎是无癌症参与者的 3 倍（4689.3 美元[4589.2 美元至 4789.3 美元]），主要用于住院服务、门诊就诊和处方药物。调整协变量后，与无癌症参与者相比，癌症幸存者每年每人额外增加医疗保健支出 4407.6 美元（3877.6 美元，4937.6 美元）（P<0.001）。癌症幸存者的直接年度医疗保健总支出从 2009-2010 年的 12960.0 美元（95%置信区间：12291.0 美元-13628.0 美元）增加到 2015-2016 年的 13807.0 美元（12828.0 美元-14787.0 美元）。
鉴于癌症幸存者的医疗支出较高，以及癌症的发病率不断上升，应通过多学科举措、合作研究，重要的是，通过医疗保健规划和政策变革来规划节省成本的措施。我们的研究结果有助于简化医疗保健资源和干预措施，制定国家医疗保健覆盖政策，并可能为癌症幸存者考虑全新的保险策略。
