Trends in Healthcare Expenditures among Adults in the United States by Cancer Diagnosis Status, 2008-2016: A Cross-Sectional Study.
Trends in Healthcare Expenditures among Adults in the United States by Cancer Diagnosis Status, 2008-2016: A Cross-Sectional Study.
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2008年至2016年美国成年人中癌症诊断状况的医疗支出趋势：一项横断面研究。
DOI：
10.1158/1055-9965.epi-21-0575
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发表时间：
2022-08-02
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这项研究旨在评估2008年至2016年期间有和没有癌症诊断的成年人之间的直接医疗支出和间接费用的趋势。使用了医疗支出小组调查（加权N = 236，811，875）的九年数据（2008-2016）。结果包括医疗支出（总支出、住院、基于办公室的、药物、门诊、牙科、急诊室就诊、家庭健康、其他）和与健康相关的误工。预测因子为既往癌症诊断。协变量包括人口统计学特征、合并症和调查完成时的日历年。使用二项分布和正分布相结合的两部分统计模型来估计医疗支出和错过的工作日。数据分为五个时间点：2008年至2009年，2010年至2011年，2012年至2013年，2014年至2015年和2016年。11%的样本（n = 25，005，230）先前有癌症诊断。与先前没有癌症诊断的人相比，先前有癌症诊断的人在所有年份的平均增量总支出更高。2008年至2016年，调整后的年度增量总支出为3，522美元[95%置信区间（CI），3，072 - 3，972美元];（1，085美元; 95% CI，990 - 1180美元）;住院治疗（810美元; 95% CI，627 - 992美元）;门诊预约（$517; 95%CI，$434-$600）;和药物（$409; 95%CI，$295-$523）;和健康相关的错过工作日（0.75; 95%CI，0.45-1.04）与没有先前癌症诊断的成年人相比。与没有癌症诊断的成年人相比，先前诊断为癌症的成年人的医疗保健支出和与健康相关的误工时间显着增加。我们的研究结果强调，随着人口的增长和老龄化，需要增加策略来弥补与癌症生存率相关的直接和间接成本增加的影响。
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. 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. 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. Adults with a prior cancer diagnosis had significantly increased healthcare expenditures and health-related missed workdays compared with those with no cancer diagnosis. 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.