Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania.
Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
JAMA Netw Open. 2021 Oct 1;4(10):e2127784. doi: 10.1001/jamanetworkopen.2021.27784.
Currently, there are limited published data regarding resource use and spending on cancer care in the US.
To characterize the most frequent medical services provided and the associated spending for privately insured patients with cancer in the US.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from the MarketScan database for the calendar year 2018 from a sample of 27.1 million privately insured individuals, including patients with a diagnosis of the 15 most prevalent cancers, predominantly from large insurers and self-insured employers. Overall societal health care spending was estimated for each cancer type by multiplying the mean total spending per patient (estimated from MarketScan) by the number of privately insured patients living with that cancer in 2018, as reported by the National Cancer Institute's Surveillance, Epidemiology, and End Results program. Analyses were performed from February 1, 2018, to July 8, 2021.
Evaluation and management as prescribed by treating care team.
Current Procedural Terminology and Healthcare Common Procedure Coding System codes based on cancer diagnosis code.
The estimated cost of cancer care in 2018 for 402 115 patients with the 15 most prevalent cancer types was approximately $156.2 billion for privately insured adults younger than 65 years in the US. There were a total of 38.4 million documented procedure codes for 15 cancers in the MarketScan database, totaling $10.8 billion. Patients with breast cancer contributed the greatest total number of services (10.9 million [28.4%]), followed by those with colorectal cancer (3.9 million [10.2%]) and prostate cancer (3.6 million [9.4%]). Pathology and laboratory tests contributed the highest number of services performed (11.7 million [30.5%]), followed by medical services (6.3 million [16.4%]) and medical supplies and nonphysician services (6.1 million [15.9%]). The costliest cancers were those of the breast ($3.4 billion [31.5%]), followed by lung ($1.1 billion [10.2%]) and colorectum ($1.1 billion [10.2%]). Medical supplies and nonphysician services contributed the highest total spent ($4.0 billion [37.0%]), followed by radiology ($2.1 billion [19.4%]) and surgery ($1.8 billion [16.7%]).
This analysis suggests that patients with breast, colorectal, and prostate cancers had the greatest number of services performed, particularly for pathology and laboratory tests, whereas patients with breast, lung, lymphoma, and colorectal cancer incurred the greatest costs, particularly for medical supplies and nonphysician services. The cost of cancer care in 2018 for the 15 most prevalent cancer types was estimated to be approximately $156.2 billion for privately insured adults younger than 65 years in the US.
目前，关于美国癌症护理的资源利用和支出，发表的数据有限。
描述美国私人保险癌症患者最常见的医疗服务和相关支出。
设计、地点和参与者：这项队列研究使用了 MarketScan 数据库 2018 年的数据，样本量为 2710 万私人保险个体，包括被诊断出 15 种最常见癌症的患者，主要来自大型保险公司和自我保险的雇主。通过将每位患者的平均总支出（根据 MarketScan 估计）乘以 2018 年 National Cancer Institute's Surveillance, Epidemiology, and End Results 项目报告的患有该癌症的私人保险患者人数，估计了每种癌症的总体社会医疗保健支出。分析于 2018 年 2 月 1 日至 2021 年 7 月 8 日进行。
根据治疗护理团队的规定进行评估和管理。
基于癌症诊断代码的当前程序术语和医疗保健通用程序编码系统代码。
对于美国 402115 名患有 15 种最常见癌症类型的私人保险成年人（年龄小于 65 岁），2018 年癌症护理的估计费用约为 1562 亿美元。MarketScan 数据库中共有 15 种癌症的 3840 万份记录程序代码，总计 108 亿美元。患有乳腺癌的患者提供的服务总数最多（1090 万[28.4%]），其次是结直肠癌患者（390 万[10.2%]）和前列腺癌患者（360 万[9.4%]）。病理和实验室检查提供的服务最多（1170 万[30.5%]），其次是医疗服务（630 万[16.4%]）和医疗用品和非医师服务（610 万[15.9%]）。最昂贵的癌症是乳腺癌（340 亿美元[31.5%]），其次是肺癌（110 亿美元[10.2%]）和结直肠癌（110 亿美元[10.2%]）。医疗用品和非医师服务的总支出最高（402 亿美元[37.0%]），其次是放射科（210 亿美元[19.4%]）和手术（180 亿美元[16.7%]）。
这项分析表明，患有乳腺癌、结直肠癌和前列腺癌的患者提供的服务最多，特别是病理和实验室检查，而患有乳腺癌、肺癌、淋巴瘤和结直肠癌的患者支出最高，特别是医疗用品和非医师服务。2018 年，美国 15 种最常见癌症类型的癌症护理费用估计约为 1562 亿美元，用于 65 岁以下的私人保险成年人。
