Medical Cost Trajectories and Onsets of Cancer and NonCancer Diseases in US Elderly Population
Medical Cost Trajectories and Onsets of Cancer and NonCancer Diseases in US Elderly Population
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DOI：
10.1155/2011/857892
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发表时间：
2011-01-01
影响因子：
--
通讯作者：
Yashin, Anatoliy I.
中科院分区：
文献类型：
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作者：
Akushevich, Igor;Kravchenko, Julia;Yashin, Anatoliy I.
使用与医疗保险服务使用文件关联的国家长期护理调查数据，分析了与 12 种与衰老相关的癌症和慢性非癌症疾病发病相关的医疗费用的时间轨迹。开发了一种用于选择每种疾病发作的个体的特殊程序，并用于确定疾病发作的日期。研究发现，医疗成本轨迹由参数模型表示，该模型具有四个易于解释的参数，反映：（i）诊断前成本（与初始合并症相关），（ii）疾病发作的成本，（iii）人口恢复代表自诊断以来与疾病相关的医疗费用的减少，以及（iv）获得性合并症代表诊断后和诊断前医疗成本水平之间的差异。这些参数针对整个美国人口以及以年龄、残疾和合并症状态以及生存（发病日期后 2.5 年）为条件的亚人群进行了评估。所开发的方法产生了一系列具有协变量的新预测模型。
Time trajectories of medical costs-associated with onset of twelve aging-related cancer and chronic noncancer diseases were analyzed using the National Long-Term Care Survey data linked to Medicare Service Use files. A special procedure for selecting individuals with onset of each disease was developed and used for identification of the date at disease onset. Medical cost trajectories were found to be represented by a parametric model with four easily interpretable parameters reflecting: (i) prediagnosis cost (associated with initial comorbidity), (ii) cost of the disease onset, (iii) population recovery representing reduction of the medical expenses associated with a disease since diagnosis was made, and (iv) acquired comorbidity representing the difference between post- and pre diagnosismedical cost levels. These parameters were evaluated for the entire US population as well as for the subpopulation conditional on age, disability and comorbidity states, and survival (2.5 years after the date of onset). The developed approach results in a family of new forecasting models with covariates.