Using Claims Data to Evaluate Radiation Therapy Utilization at the End of Life

使用索赔数据评估临终放射治疗的使用情况

• 批准号: 8540986
• 负责人: Beverly A Guadagnolo
• 金额: $ 16.76万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-06 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8540986
• 关键词: Address; Advanced Malignant Neoplasm; Biometry; Breast; Canada; Cancer Etiology; Cancer Patient; Caring; Cessation of life; Characteristics; Charge; Code; Colorectal Cancer; Complex; Cost Analysis; Data; Databases; Diagnosis; Diagnostic Neoplasm Staging; Diffusion; Dose; Economics; Ensure; Evidence based practice; Gender; Germany; Goals; Grant; Health Care Costs; Health Services; Health Services Research; Healthcare; Human Resources; Insurance; Insurance Claim Review; Intensity-Modulated Radiotherapy; Length; Life; Link; Living Costs; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of pancreas; Malignant neoplasm of prostate; Measures; Medical Surveillance; Medicare; Methodology; Metric; Modality; Modeling; Outcome; Patients; Pattern; Policies; Positioning Attribute; Procedures; Program Sustainability; Radiation; Radiation Oncologist; Radiation Oncology; Radiation therapy; Recommendation; Regimen; Reporting; Research; Research Personnel; Resources; Surveys; Symptoms; Technology; Texas; Time; Translating; United States; Variant; Work; care delivery; cohort; cost; cost effective; cost effectiveness; design; end of life; evidence base; improved; multidisciplinary; neoplasm registry; older patient; palliation; palliative; population based; tertiary care; treatment duration; trend

DESCRIPTION (provided by applicant): The proposed work seeks to use the Surveillance Epidemiology and End Results-Medicare and Texas Cancer Registry-Medicare linked databases to analyze claims data to evaluate radiation therapy utilization and costs at the end of life as well as the use of advanced radiation therapy technology at the end of life. The specific advanced radiation techonology to be studied will be intensity modulated radiation therapy (IMRT) a complex and expensive modality without proven palliative benefit, despite the fact that investigators have found that 57% of radiation oncologists use this modality for palliation. This grant will perform analyses of claims data using diagnosis and procedure codes to use the claims data to ascertain what may represent over-aggressive radiation therapy treatment at the end of life for cancer patients with the five most common causes of cancer death in the United states (breast, colorectal, lung, pancreatic, and prostate cancers). The specific aims are: 1) to assess the utilization (i.e., proportion receiving), intensity of utilization (i.e., number of treatements) of radiation therapy in the last 30 days of life, and costs as well as socio-demographic and health services factors that may be associated with radiation therapy receipt in the last 30 days of life; and 2) to explore the trends in IMRT utilization among cancers patients receiving radiation therapy in the last 30 days of life. Regression models will be used to determine socio-demographic and health services characteristics that may be significantly associated with receipt of radiation therapy or IMRT at the end of life. Currently, there are no data from U.S. cohorts reporting on RT utilization and advanced radiation therapy technology diffusion, such as IMRT, at the end of life. Thus, this proposed work would provide unique, population-based data regarding end of life care for elderly patients in the U.S. Long-term objectives include establishing data and methodology to serve as preliminary work toward a larger R-01 study proposal to employ claims data to analyze the costs and cost effectiveness associated with radiation therapy utilization and advanced radiation therapy technologies at the end of life for cancer patients.

描述（由申请人提供）：拟议的工作旨在使用监测流行病学和最终结果-医疗保险和得克萨斯州癌症登记-医疗保险链接数据库来分析索赔数据，以评估生命结束时的放射治疗利用率和成本以及生命结束时先进放射治疗技术的使用。要研究的特定先进放射技术将是调强放射治疗（IMRT），这是一种复杂而昂贵的方式，没有证明姑息治疗的好处，尽管研究人员发现57%的放射肿瘤学家使用这种方式进行姑息治疗。该补助金将使用诊断和程序代码对索赔数据进行分析，以使用索赔数据来确定在美国癌症死亡的五种最常见原因（乳腺癌，结肠直肠癌，肺癌，胰腺癌和前列腺癌）的癌症患者生命结束时可能代表过度积极的放射治疗。具体目标是：1）评估利用率（即，比例接收），利用强度（即，研究目的：（1）探讨生命最后30天内接受放射治疗的癌症患者的IMRT使用情况，以及与生命最后30天内接受放射治疗相关的成本、社会人口统计学和卫生服务因素;（2）探讨生命最后30天内接受放射治疗的癌症患者IMRT使用趋势。回归模型将用于 确定可能与生命末期接受放射治疗或IMRT显著相关的社会人口统计学和卫生服务特征。目前，没有来自美国队列的数据报告在生命末期的RT利用和先进放射治疗技术扩散，如IMRT。因此，这项拟议的工作将提供独特的，长期目标包括建立数据和方法，作为更大的R-01研究提案的初步工作，以采用索赔数据分析癌症患者生命末期放射治疗利用和先进放射治疗技术相关的成本和成本效益。

项目成果

Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.

• DOI: 10.1097/coc.0b013e31829378f9
• 发表时间: 2015-06
• 期刊: American journal of clinical oncology
• 作者: Huo J;Du XL;Lairson DR;Chan W;Jiang J;Buchholz TA;Guadagnolo BA
• 通讯作者: Guadagnolo BA