Sierro Tiffany J, Blumenthal Laura Y, Hekmatjah Joshua, Chat Vipawee S, Kassardjian Ari A, Read Charlotte, Armstrong April W
University of Southern California Keck School of Medicine, Los Angeles, California.
Center for Dermatology Care, Thousand Oaks, California.
J Am Acad Dermatol. 2022 Feb;86(2):373-378. doi: 10.1016/j.jaad.2021.07.005. Epub 2021 Jul 9.
As the United States becomes more diverse, determining differences in health care utilization and costs in the management of skin cancers is fundamental to decision-making in health care resource allocation and improving care for underserved populations.
To compare health care use and costs among non-Hispanic White, Hispanic White, and non-Hispanic Black patients with keratinocyte carcinoma.
A nationwide cross-sectional study was performed using Medical Expenditure Panel Survey data from 1996 to 2015.
Among 54,503,447 patients with keratinocyte carcinoma (weighted) over a 20-year period, 53,134,351 (97%) were non-Hispanic White; 836,030 (1.5%) were Hispanic White; and 170,755 (0.3%) were non-Hispanic Black. Compared to non-Hispanic White patients, Hispanic White patients had significantly more ambulatory visits per person per year (5.4 vs 3.5, P = .003). Compared to non-Hispanic White patients, non-Hispanic Black patients had significantly more ambulatory visits (13.1 vs 3.5, P = .027) and emergency department visits (2.3 vs 1.1, P < .001), and incurred significantly higher ambulatory costs ($5089 vs $1131, P = .05), medication costs ($523 vs $221, P = .022), and total costs per person per year ($13,430 vs $1290, P = .032).
Data for squamous cell carcinomas and basal cell carcinomas are combined.
Keratinocyte carcinoma was more costly to treat and required more health care resources in non-Hispanic Black and Hispanic White patients than in non-Hispanic White patients.
随着美国人口日益多样化,确定皮肤癌治疗中医疗保健利用和成本的差异对于医疗保健资源分配决策以及改善对服务不足人群的护理至关重要。
比较非西班牙裔白人、西班牙裔白人和非西班牙裔黑人角质形成细胞癌患者的医疗保健使用情况和成本。
利用1996年至2015年医疗支出面板调查数据进行了一项全国性横断面研究。
在20年期间的54503447例(加权)角质形成细胞癌患者中,53134351例(97%)为非西班牙裔白人;836030例(1.5%)为西班牙裔白人;170755例(0.3%)为非西班牙裔黑人。与非西班牙裔白人患者相比,西班牙裔白人患者每人每年的门诊就诊次数显著更多(5.4次对3.5次,P = 0.003)。与非西班牙裔白人患者相比,非西班牙裔黑人患者的门诊就诊次数显著更多(13.1次对3.5次,P = 0.027),急诊就诊次数也显著更多(2.3次对1.1次,P < 0.001),且门诊费用(5089美元对1131美元,P = 0.05)、药物费用(523美元对221美元,P = 0.022)以及每人每年的总费用(13430美元对1290美元,P = 0.032)均显著更高。
鳞状细胞癌和基底细胞癌的数据合并在一起。
与非西班牙裔白人患者相比,非西班牙裔黑人和西班牙裔白人角质形成细胞癌患者的治疗成本更高,需要更多的医疗保健资源。