Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020
Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goal...
Ausführliche Beschreibung
Autor*in: |
Taparra, Kekoa [verfasserIn] |
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Englisch |
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2021 |
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Anmerkung: |
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 |
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Übergeordnetes Werk: |
Enthalten in: Supportive care in cancer - Berlin : Springer, 1993, 30(2021), 2 vom: 26. Sept., Seite 1703-1713 |
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Übergeordnetes Werk: |
volume:30 ; year:2021 ; number:2 ; day:26 ; month:09 ; pages:1703-1713 |
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DOI / URN: |
10.1007/s00520-021-06584-0 |
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SPR045878145 |
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520 | |a Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer. | ||
650 | 4 | |a AYA cancer |7 (dpeaa)DE-He213 | |
650 | 4 | |a Financial burden |7 (dpeaa)DE-He213 | |
650 | 4 | |a Cancer costs |7 (dpeaa)DE-He213 | |
650 | 4 | |a Health care costs |7 (dpeaa)DE-He213 | |
650 | 4 | |a Financial toxicity |7 (dpeaa)DE-He213 | |
700 | 1 | |a Fitzsimmons, Alec |4 aut | |
700 | 1 | |a Frankki, Susan |4 aut | |
700 | 1 | |a De Wall, Andrea |4 aut | |
700 | 1 | |a Chino, Fumiko |4 aut | |
700 | 1 | |a Peters, Antoinette |4 aut | |
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10.1007/s00520-021-06584-0 doi (DE-627)SPR045878145 (SPR)s00520-021-06584-0-e DE-627 ger DE-627 rakwb eng Taparra, Kekoa verfasserin (orcid)0000-0001-8493-3868 aut Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer. AYA cancer (dpeaa)DE-He213 Financial burden (dpeaa)DE-He213 Cancer costs (dpeaa)DE-He213 Health care costs (dpeaa)DE-He213 Financial toxicity (dpeaa)DE-He213 Fitzsimmons, Alec aut Frankki, Susan aut De Wall, Andrea aut Chino, Fumiko aut Peters, Antoinette aut Enthalten in Supportive care in cancer Berlin : Springer, 1993 30(2021), 2 vom: 26. Sept., Seite 1703-1713 (DE-627)254909574 (DE-600)1463166-0 1433-7339 nnns volume:30 year:2021 number:2 day:26 month:09 pages:1703-1713 https://dx.doi.org/10.1007/s00520-021-06584-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 30 2021 2 26 09 1703-1713 |
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10.1007/s00520-021-06584-0 doi (DE-627)SPR045878145 (SPR)s00520-021-06584-0-e DE-627 ger DE-627 rakwb eng Taparra, Kekoa verfasserin (orcid)0000-0001-8493-3868 aut Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer. AYA cancer (dpeaa)DE-He213 Financial burden (dpeaa)DE-He213 Cancer costs (dpeaa)DE-He213 Health care costs (dpeaa)DE-He213 Financial toxicity (dpeaa)DE-He213 Fitzsimmons, Alec aut Frankki, Susan aut De Wall, Andrea aut Chino, Fumiko aut Peters, Antoinette aut Enthalten in Supportive care in cancer Berlin : Springer, 1993 30(2021), 2 vom: 26. Sept., Seite 1703-1713 (DE-627)254909574 (DE-600)1463166-0 1433-7339 nnns volume:30 year:2021 number:2 day:26 month:09 pages:1703-1713 https://dx.doi.org/10.1007/s00520-021-06584-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 30 2021 2 26 09 1703-1713 |
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10.1007/s00520-021-06584-0 doi (DE-627)SPR045878145 (SPR)s00520-021-06584-0-e DE-627 ger DE-627 rakwb eng Taparra, Kekoa verfasserin (orcid)0000-0001-8493-3868 aut Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer. AYA cancer (dpeaa)DE-He213 Financial burden (dpeaa)DE-He213 Cancer costs (dpeaa)DE-He213 Health care costs (dpeaa)DE-He213 Financial toxicity (dpeaa)DE-He213 Fitzsimmons, Alec aut Frankki, Susan aut De Wall, Andrea aut Chino, Fumiko aut Peters, Antoinette aut Enthalten in Supportive care in cancer Berlin : Springer, 1993 30(2021), 2 vom: 26. Sept., Seite 1703-1713 (DE-627)254909574 (DE-600)1463166-0 1433-7339 nnns volume:30 year:2021 number:2 day:26 month:09 pages:1703-1713 https://dx.doi.org/10.1007/s00520-021-06584-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 30 2021 2 26 09 1703-1713 |
allfieldsGer |
10.1007/s00520-021-06584-0 doi (DE-627)SPR045878145 (SPR)s00520-021-06584-0-e DE-627 ger DE-627 rakwb eng Taparra, Kekoa verfasserin (orcid)0000-0001-8493-3868 aut Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer. AYA cancer (dpeaa)DE-He213 Financial burden (dpeaa)DE-He213 Cancer costs (dpeaa)DE-He213 Health care costs (dpeaa)DE-He213 Financial toxicity (dpeaa)DE-He213 Fitzsimmons, Alec aut Frankki, Susan aut De Wall, Andrea aut Chino, Fumiko aut Peters, Antoinette aut Enthalten in Supportive care in cancer Berlin : Springer, 1993 30(2021), 2 vom: 26. Sept., Seite 1703-1713 (DE-627)254909574 (DE-600)1463166-0 1433-7339 nnns volume:30 year:2021 number:2 day:26 month:09 pages:1703-1713 https://dx.doi.org/10.1007/s00520-021-06584-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 30 2021 2 26 09 1703-1713 |
allfieldsSound |
10.1007/s00520-021-06584-0 doi (DE-627)SPR045878145 (SPR)s00520-021-06584-0-e DE-627 ger DE-627 rakwb eng Taparra, Kekoa verfasserin (orcid)0000-0001-8493-3868 aut Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer. AYA cancer (dpeaa)DE-He213 Financial burden (dpeaa)DE-He213 Cancer costs (dpeaa)DE-He213 Health care costs (dpeaa)DE-He213 Financial toxicity (dpeaa)DE-He213 Fitzsimmons, Alec aut Frankki, Susan aut De Wall, Andrea aut Chino, Fumiko aut Peters, Antoinette aut Enthalten in Supportive care in cancer Berlin : Springer, 1993 30(2021), 2 vom: 26. Sept., Seite 1703-1713 (DE-627)254909574 (DE-600)1463166-0 1433-7339 nnns volume:30 year:2021 number:2 day:26 month:09 pages:1703-1713 https://dx.doi.org/10.1007/s00520-021-06584-0 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 30 2021 2 26 09 1703-1713 |
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Enthalten in Supportive care in cancer 30(2021), 2 vom: 26. Sept., Seite 1703-1713 volume:30 year:2021 number:2 day:26 month:09 pages:1703-1713 |
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Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. 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Taparra, Kekoa |
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Taparra, Kekoa misc AYA cancer misc Financial burden misc Cancer costs misc Health care costs misc Financial toxicity Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 |
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Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 AYA cancer (dpeaa)DE-He213 Financial burden (dpeaa)DE-He213 Cancer costs (dpeaa)DE-He213 Health care costs (dpeaa)DE-He213 Financial toxicity (dpeaa)DE-He213 |
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Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 |
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Taparra, Kekoa Fitzsimmons, Alec Frankki, Susan De Wall, Andrea Chino, Fumiko Peters, Antoinette |
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health care costs for adolescents and young adults with cancer: a wisconsin community-based hospital study between 2005 and 2020 |
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Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 |
abstract |
Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 |
abstractGer |
Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 |
abstract_unstemmed |
Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 |
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title_short |
Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020 |
url |
https://dx.doi.org/10.1007/s00520-021-06584-0 |
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Fitzsimmons, Alec Frankki, Susan De Wall, Andrea Chino, Fumiko Peters, Antoinette |
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Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15–39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30–39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73–$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35–2.27), chemotherapy (OR = 4.1, 95% CI = 1.44–12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07–14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02–0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55–0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01–0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22–27.80) and radiation (HR = 31.8, 95% CI = 3.15–321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01–0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12–0.60). 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score |
7.3982143 |