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American journal of cancer science最新文献

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Cancer Treatment for Dual Eligibles: What Are the Costs and Who Pays? 双重资格的癌症治疗:费用是什么,谁来支付?
Pub Date : 2013-01-01 Epub Date: 2013-04-29
Susan G Haber, Florence K L Tangka, Lisa C Richardson, Susan A Sabatino, David Howard

This study quantifies treatment costs for melanoma and breast, cervical, colorectal, lung, and prostate cancer among patients with dual Medicare and Medicaid eligibility. The analyses use merged Medicare and Medicaid Analytic eXtract enrollment and claims data for dually eligible beneficiaries age>18 in Georgia, Illinois, Louisiana, and Maine in 2003 (n=892,001). We applied ordinary least squares regression analysis to estimate annual expenditures attributable to each cancer after controlling for beneficiaries' age, race/ethnicity, sex, and comorbid conditions, and state fixed effects. Cancers and comorbid conditions were identified on the basis of diagnosis codes on insurance claims. The most prevalent cancers were prostate (38.4 per 1,000 men) and breast (30.7 per 1,000 women). Dual eligibles with the study cancers had higher rates of other chronic conditions such as hypertension and arthritis than other beneficiaries. Total Medicare and Medicaid expenditures for dual eligibles with the study cancers ranged from $30,328 for those with lung cancer to $17,011 for those with breast cancer, compared with $10,664 for beneficiaries without the cancers. However, only 9% to 30% of medical expenditures for dual eligibles with the study cancers were attributable to the cancer itself. In 2003, combined Medicare/Medicaid spending for dual eligibles attributable to the six cancers in the four study states exceeded $256 million ($314 million in 2012 dollars). Dual eligibles with these cancers also had high rates of other medical conditions. These comorbidities should be recognized, both in documenting cancer treatment costs and in developing programs and policies that promote timely cancer diagnosis and treatment.

本研究量化了具有双重医疗保险和医疗补助资格的黑色素瘤、乳腺癌、宫颈癌、结肠直肠癌、肺癌和前列腺癌患者的治疗费用。分析使用合并的医疗保险和医疗补助分析提取登记和索赔数据,这些数据是2003年在乔治亚州、伊利诺伊州、路易斯安那州和缅因州双重符合条件的受益人(n=892,001)。在控制了受益人的年龄、种族/民族、性别、合并症和州固定效应后,我们应用普通最小二乘回归分析来估计归因于每种癌症的年度支出。癌症和合并症是根据保险索赔的诊断代码确定的。最常见的癌症是前列腺癌(每1000名男性38.4例)和乳腺癌(每1000名女性30.7例)。与其他受益人相比,患有癌症的双重资格患者患高血压和关节炎等其他慢性疾病的几率更高。双重医疗保险和医疗补助的总支出范围从肺癌患者的30328美元到乳腺癌患者的17011美元不等,而没有癌症的受益人为10664美元。然而,只有9%到30%的双重资格的研究癌症患者的医疗支出可归因于癌症本身。2003年,在四个研究州中,针对六种癌症的双重资格的医疗保险/医疗补助支出总额超过2.56亿美元(按2012年的美元价值计算为3.14亿美元)。患有这些癌症的双重资格患者也有很高的其他医疗条件。在记录癌症治疗费用和制定促进及时癌症诊断和治疗的计划和政策时,应该认识到这些合并症。
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American journal of cancer science
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