Affiliation:
1. 1Institute for Health and Equity (IHE), Medical College of Wisconsin, Milwaukee, Wisconsin.
2. 2Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, Wisconsin.
3. 3Department of Medicine, Division of General Internal Medicine, Froedtert & the Medical College of Wisconsin, Milwaukee, Wisconsin.
Abstract
Abstract
Background:
This study aims to assess trends in direct medical expenditures and indirect costs between adults with and without a prior cancer diagnosis from 2008 to 2016.
Methods:
Nine years of data (2008–2016) from the Medical Expenditure Panel Survey (weighted N = 236,811,875) were used. The outcomes included medical expenditures (total expenditure, inpatient, office-based, medications, outpatient, dental, emergency room visits, home health, other) and health-related missed workdays. The predictor was prior cancer diagnosis. Covariates included demographic characteristics, comorbidities, and calendar year at time of survey completion. Two-part statistical modeling with a combination of binomial and positive distributions was used to estimate medical expenditures and missed workdays. Data were clustered into five timepoints: 2008 to 2009, 2010 to 2011, 2012 to 2013, 2014 to 2015, and 2016.
Results:
Eleven percent of the sample (n = 25,005,230) had a prior cancer diagnosis. Compared with those without a prior cancer diagnosis, those with a prior cancer diagnosis had higher mean incremental total expenditures across all years. Between 2008 and 2016, the adjusted annual incremental total expenditures were $3,522 [95% confidence interval (CI), $3,072–$3,972]; office-based visits ($1,085; 95% CI, $990–$1180); inpatient hospitalizations ($810; 95% CI, $627–$992); outpatient appointments ($517; 95% CI, $434–$600); and medications ($409; 95% CI, $295–$523); and health-related missed workdays (0.75; 95% CI, 0.45–1.04) compared with adults without a prior cancer diagnosis.
Conclusions:
Adults with a prior cancer diagnosis had significantly increased healthcare expenditures and health-related missed workdays compared with those with no cancer diagnosis.
Impact:
Our findings highlight the need for increasing strategies to remedy the impact of increasing direct and indirect costs associated with cancer survivorship as the population grows and ages.
Funder
National Institute of Diabetes and Digestive and Kidney Diseases
Publisher
American Association for Cancer Research (AACR)
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