Total and out-of-pocket expenditures among women with metastatic breast cancer in low-deductible versus high-deductible health plans.
Total and out-of-pocket expenditures among women with metastatic breast cancer in low-deductible versus high-deductible health plans.
复制标题
DOI：
10.1007/s10549-018-4819-6
复制
发表时间：
2018-09
影响因子：
3.8
通讯作者：
Wharam JF
中科院分区：
文献类型：
--
作者：
Leopold C;Wagner AK;Zhang F;Lu CY;Earle CC;Nekhlyudov L;Ross-Degnan D;Wharam JF
High-deductible health plan (HDHP) enrollment is expanding rapidly and might substantially increase out-of-pocket (OOP) payment burden. We examined trends in total and OOP health service expenditures overall and by insurance coverage type among women with metastatic breast cancer. We used a longitudinal time series design to examine measures among 5364 women with metastatic breast cancer insured by a large US health insurer from 2004 to 2011. We measured outcomes during the 12 months after a first identified metastatic breast cancer diagnosis and required women to have at least 6 months of prior enrollment. We plotted enrollment measures and adjusted spending and fit trend lines using linear first-order autoregressive models. Between 2004-2011, the percentage of women with metastatic breast cancer enrolled in HDHPs increased from 8% to 23% while the percentage enrolled in low-deductible plans (LDHPs) decreased from 69% to 37%. Over the same time period, estimated inflation-adjusted total health service spending per person-year increased from $96,899 to $104,688 (increase of $1,197 per year; 95% confidence interval [CI]: $47,$2,348). Corresponding OOP spending values were $4,496 and $5,151 ($91 per year trend; 95% CI: −$13,$195). Women in HDHPs and LDHPs had estimated annual OOP spending of $6,642 (95% CI: $6,268,$7,016) and $4,247 (95% CI: $3,956,$4,538), respectively. OOP spending among women with metastatic breast cancer was 55% higher among HDHP than LDHP members, and HDHP enrollment increased substantially from 2004-2011. Stakeholders and policymakers should design health plans that protect financially vulnerable cancer patients from high OOP costs.
登录
查看更多内容
DOI：
10.1093/jnci/djv048
发表时间：
2015-06
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Kohler BA;Sherman RL;Howlader N;Jemal A;Ryerson AB;Henry KA;Boscoe FP;Cronin KA;Lake A;Noone AM;Henley SJ;Eheman CR;Anderson RN;Penberthy L
通讯作者：
Penberthy L
影响因子：
3.8
作者：
DeSantis, Carol E.;Bray, Freddie;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin
影响因子：
3.8
作者：
Barron, John J.;Quimbo, Ralph;Amonkar, Mayur M.
通讯作者：
Amonkar, Mayur M.
影响因子：
2.4
作者：
Fu, Alex Z;Jhaveri, Mehul
通讯作者：
Jhaveri, Mehul
影响因子：
9.7
作者：
Banegas, Matthew P.;Guy, Gery P., Jr.;Yabroff, K. Robin
通讯作者：
Yabroff, K. Robin