Hoover Alex, Watson Dave, Reimche Paige, Tanner Lynn, Gilchrist Laura, Finch Mike, Messinger Yoav H, Turcotte Lucie M
Optum Labs Visiting Fellow, Division of Pediatric Blood and Marrow Transplantation, University of Minnesota Medical School, Mayo Mail Code 366, 420 Delaware St SE, 55455, Minneapolis, MN, USA.
Children's Minnesota, Minneapolis, MN, USA.
BMC Res Notes. 2024 Apr 22;17(1):112. doi: 10.1186/s13104-024-06768-x.
Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy and among the most common malignancies in young adults and requires a unique pattern of healthcare utilization including an acute/emergent presentation and an intensive initial 8 months of therapy followed by two years of outpatient treatment. The COVID-19 pandemic caused massive global disruptions in healthcare use and delivery. This report aims to examine the effects of the COVID-19 pandemic on the presentation, diagnosis and continued management of childhood and young adult ALL in regard to utilization and cost of care among commercially insured individuals in the United States.
Utilizing a commercial insurance claims database, 529 pediatric and young adult patients were identified who were diagnosed with ALL between January 2016 and March 2021. New diagnoses were evaluated by era and demographics. Utilization was measured by COVID-related era as number of inpatient and outpatient encounters, inpatient days, and cumulative cost during the initial 8 months of therapy. None of these cost or utilization factors changed significantly during or shortly after the pandemic. These findings reinforce that the necessary care for pediatric and young adult ALL was unwavering despite the massive shifts in the healthcare system caused by the COVID-19 pandemic. This provides a valuable benchmark as we further examine the factors that influence the pandemic's impact on health equity and access to care, especially in vulnerable pediatric and young adult populations. This is the first investigation of the effect of the COVID-19 pandemic on utilization and cost of care in pediatric and young adult cancer.
急性淋巴细胞白血病（ALL）是儿童期最常见的恶性肿瘤，也是年轻成年人中最常见的恶性肿瘤之一，需要独特的医疗服务利用模式，包括急性/紧急就诊以及最初8个月的强化治疗，随后是两年的门诊治疗。新冠疫情在全球范围内对医疗服务的使用和提供造成了巨大干扰。本报告旨在研究新冠疫情对美国商业保险参保人群中儿童及年轻成人ALL的就诊、诊断及持续管理在医疗服务利用和护理成本方面的影响。
利用商业保险理赔数据库，确定了529名在2016年1月至2021年3月期间被诊断为ALL的儿科和年轻成人患者。按时代和人口统计学特征对新诊断病例进行评估。以与新冠相关的时代为依据，通过住院和门诊就诊次数、住院天数以及治疗最初8个月期间的累计费用来衡量医疗服务利用情况。在疫情期间或疫情刚结束后，这些成本或利用因素均未发生显著变化。这些发现强化了一点，即尽管新冠疫情导致医疗系统发生了巨大变化，但对儿科和年轻成人ALL的必要护理始终没有动摇。这为我们进一步研究影响疫情对健康公平性和医疗服务可及性的因素提供了一个有价值的基准，尤其是在脆弱的儿科和年轻成人人群中。这是首次对新冠疫情对儿科和年轻成人癌症医疗服务利用及护理成本的影响进行调查。
