PRECISIONheor, Bethesda, MD.
Genesis Research, Hoboken, NJ.
JCO Oncol Pract. 2023 May;19(5):e660-e671. doi: 10.1200/OP.22.00555. Epub 2023 Feb 17.
Mental health comorbidities are commonplace among patients with cancer and have been associated with adverse health outcomes and elevated health care costs. Given the rapidly evolving cancer care landscape, an updated understanding of the prevalence and costs of mental health conditions among patients with cancer is needed. This study assessed the incremental costs of anxiety and depression among Medicare beneficiaries with cancer.
This retrospective cohort study used the SEER-Medicare database. Patients diagnosed with melanoma, breast, lung, prostate, or colorectal cancer between July 2013 and December 2017 were followed for at least 12 months and up to 36 months after cancer diagnosis. Patients were categorized on the basis of anxiety/depression (AD) diagnosis: (1) predating cancer, (2) onset after cancer, or (3) no AD. Multivariable regression was used to estimate differences in all-cause incremental costs (before after cancer) between the three groups.
Of 230,626 patients, 10% had AD before their cancer diagnosis and 22% were diagnosed after cancer. In the first year after cancer diagnosis, average monthly health care costs were $5,750 in US dollars (USD) for patients with newly onset, $5,208 (USD) for patients with preexisting, and $3,919 (USD) for patients without a diagnosis of AD. The incremental cost of cancer was the greatest among patients with newly onset AD-$1,458 (USD) per month greater than those with no AD. Similar patterns were observed across cancer types and stages.
One in three Medicare beneficiaries with cancer in this study had a diagnosis of anxiety or depression. Newly onset AD is associated with an increase in health care costs of $17,496 (USD) per year. Screening and management of mental health conditions for patients with cancer should be part of coordinated oncology care.
癌症患者中常见精神健康合并症，且与不良健康结局和医疗保健费用增加相关。鉴于癌症护理领域的快速发展，需要了解癌症患者精神健康状况的患病率和成本的最新情况。本研究评估了医疗保险受益人群中癌症患者焦虑和抑郁的增量成本。
这是一项回顾性队列研究，使用了 SEER-Medicare 数据库。2013 年 7 月至 2017 年 12 月期间，被诊断患有黑色素瘤、乳腺癌、肺癌、前列腺癌或结直肠癌的患者被随访至少 12 个月，最长可达癌症诊断后 36 个月。根据焦虑/抑郁（AD）诊断将患者分为以下三类：（1）癌症前发生，（2）癌症后发生，或（3）无 AD。多变量回归用于估计三组间所有原因增量成本（癌症前/后）的差异。
在 230626 名患者中，10%在癌症诊断前有 AD，22%在癌症后被诊断出患有 AD。在癌症诊断后的第一年，新发 AD 患者的月平均医疗保健费用为 5750 美元，有既往 AD 患者为 5208 美元，无 AD 患者为 3919 美元。新发 AD 患者的癌症增量成本最高，比无 AD 患者每月高出 1458 美元。在不同癌症类型和阶段中也观察到类似的模式。
在这项研究中，每 3 名医疗保险受益的癌症患者中就有 1 名被诊断出患有焦虑或抑郁。新发 AD 与每年增加 17496 美元的医疗保健费用相关。癌症患者的精神健康状况筛查和管理应成为综合肿瘤学护理的一部分。
