McDaniel Cassidi C, Loh F Ellen, Rockwell Devan M, McDonald Courtney P, Chou Chiahung
Auburn University, Harrison School of Pharmacy, Department of Health Outcomes Research and Policy, Auburn, AL, USA.
Touro College of Pharmacy, Department of Social, Behavioral, and Administrative Sciences, New York, NY, USA.
J Pharm Health Serv Res. 2021 Mar 6;12(2):142-151. doi: 10.1093/jphsr/rmab002. eCollection 2021 Jun.
Older adults are commonly affected by cancer and diabetes, and an investigation of the economic burden faced by these older adults remains a research gap. Therefore, the objective was to assess the economic burden of diabetes among Medicare beneficiaries with cancer by analyzing annual costs from administrative claims data.
We conducted a retrospective, serial cross-sectional study using the Medicare Current Beneficiary Survey (MCBS) from 2006 to 2012. Eligible beneficiaries must be currently or previously diagnosed with cancer (of any type), ≥65 years of age, non-institutionalized and continuously enrolled annually in Medicare Parts A, B and D. Diagnoses of cancer and diabetes were determined through self-report or claims. The primary outcome was the total economic burden of diabetes per capita annually, operationalized as the difference in total direct costs between cancer patients with and without diabetes. Simple linear regression was used to analyze trends of costs across the years. Multivariable regression estimated the effect of diabetes and covariates on total annual spending among beneficiaries with cancer from 2006-2012.
From 2006 to 2012, 4918 beneficiaries included in MCBS had cancer, with over 25% (1275) also having diabetes. From 2006 to 2012, the mean economic burden of diabetes was $7815 per capita annually. After adjusting for covariates, beginning in 2006, diagnosis of diabetes significantly predicted higher total annual spending among cancer beneficiaries in 2007 [coefficient (SE) = 0.5768 (0.1918), = 0.003], 2011 [coefficient (SE) = 0.4303 (0.1817), = 0.018] and 2012 [coefficient (SE) = 0.3605 (0.1758), = 0.040].
Medicare beneficiaries with cancer experienced a higher economic burden from concurrent diabetes.
老年人常受癌症和糖尿病影响，对这些老年人所面临经济负担的调查仍是一个研究空白。因此，本研究的目的是通过分析行政索赔数据中的年度费用，评估患有癌症的医疗保险受益人中糖尿病的经济负担。
我们使用2006年至2012年的医疗保险当前受益人调查（MCBS）进行了一项回顾性、系列横断面研究。符合条件的受益人必须目前或既往被诊断患有任何类型的癌症，年龄≥65岁，非机构化且每年持续参加医疗保险A、B和D部分。癌症和糖尿病的诊断通过自我报告或索赔确定。主要结局是人均每年糖尿病的总经济负担，定义为患有和未患有糖尿病的癌症患者之间直接费用总额的差异。使用简单线性回归分析各年份费用趋势。多变量回归估计了2006 - 2012年糖尿病及协变量对癌症受益人年度总支出的影响。
2006年至2012年，MCBS纳入的4918名受益人患有癌症，其中超过25%（1275名）也患有糖尿病。2006年至2012年，糖尿病的平均经济负担为人均每年7815美元。在对协变量进行调整后，从2006年开始，糖尿病诊断显著预测了2007年[系数（标准误）= 0.5768（0.1918），P = 0.003]、2011年[系数（标准误）= 0.4303（0.1817），P = 0.018]和2012年[系数（标准误）= 0.3605（0.1758），P = 0.040]癌症受益人的年度总支出更高。
患有癌症的医疗保险受益人同时患有糖尿病时会承受更高的经济负担。
