Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Public Health, College of Health Sciences Sam Houston State University, Huntsville, TX.
Department of Biostatistics, Columbia University, New York City, NY, USA.
Value Health. 2023 Oct;26(10):1444-1452. doi: 10.1016/j.jval.2023.06.003. Epub 2023 Jun 20.
This study applied a recently developed statistical method to compare the mean cost trajectories between non-Hispanic White (NHW) and non-Hispanic Black (NHB) patients with localized prostate cancer conditioning on patients' survival.
In this observational study, we modeled cost trajectories of NHW and NHB patients with localized prostate cancer for 3 survival durations: 24, 48, and 72 months. We also compared the cost trajectories between NHW and NHB, stratified by comorbidities scores.
We find that the mean cost trajectories of NHB were significantly higher than the trajectories of NHW in the last 12 months before death, regardless of the survival duration and patients' baseline comorbidity scores. For patients with comorbidity score ≥2, mean cost trajectories within the first year of diagnosis for NHB were significantly higher than those for NHW, except for the subgroup of patients with comorbidity 2-3 and whose survival length was 72 months.
Our results suggested that a higher proportion of NHB patients with high comorbidity scores are likely contribute to their higher end-of-life costs than those for NHW patients. To narrow the gap in healthcare-related financial burden between NHB and NHW patients with localized prostate cancer, policy makers need to explore different strategies to better manage comorbidities.
本研究应用一种新开发的统计方法,比较了在考虑患者生存的情况下,局部前列腺癌患者中,非西班牙裔白人(NHW)和非西班牙裔黑人(NHB)的平均成本轨迹。
在这项观察性研究中,我们为具有局部前列腺癌的 NHW 和 NHB 患者建模了 3 种生存时间的成本轨迹:24、48 和 72 个月。我们还按合并症评分对 NHW 和 NHB 之间的成本轨迹进行了分层比较。
我们发现,无论生存时间和患者的基线合并症评分如何,NHB 的平均成本轨迹在死亡前的最后 12 个月内均显著高于 NHW 的成本轨迹。对于合并症评分≥2 的患者,除了合并症为 2-3 且生存时间为 72 个月的亚组外,NHB 在诊断后第一年的平均成本轨迹显著高于 NHW。
我们的结果表明,高合并症评分的 NHB 患者的成本轨迹可能比 NHW 患者的成本轨迹更高,这可能导致他们在生命末期的费用更高。为了缩小局部前列腺癌患者中 NHW 和 NHB 在医疗保健相关财务负担方面的差距,政策制定者需要探索不同的策略来更好地管理合并症。