Economic burden of cancer among patients with surgical resections of the lung, rectum, liver and uterus: results from a US hospital database claims analysis

Kalsekar, Iftekhar; Hsiao, Chia‐Wen; Cheng, Hang; Yadalam, Sashi; Chen, Brian Po-Han; Goldstein, Laura; Yoo, Andrew

doi:10.1186/s13561-017-0160-8

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…The data source was a US database of inpatient hospital encounters comprised of 193 US hospitals, 6235171 patients, and 4.16 years from May 2014 to June 2018 (Premier, Inc., Charlotte, NC, USA). This database was previously employed in disease areas including myocardial infarction [20], pneumonia [21], gram-negative infections [22], and cancer [23]. A hospital encounter was defined as a discrete patient stay from admission to discharge.…”

Section: Methodsmentioning

confidence: 99%

ESKAPE Pathogens in Bloodstream Infections Are Associated With Higher Cost and Mortality but Can Be Predicted Using Diagnoses Upon Admission

Marturano

Lowery

2019

Open Forum Infectious Diseases

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Background ESKAPE bacteria are thought to be especially resistant to antibiotics, and their resistance and prevalence in bloodstream infections are rising. Large studies are needed to better characterize the clinical impact of these bacteria and to develop algorithms that alert clinicians when patients are at high risk of an ESKAPE infection. Methods From a US data set of >1.1 M patient encounters, we evaluated if ESKAPE pathogens produced worse outcomes than non-ESKAPE pathogens and if an ESKAPE infection could be predicted using simple word group algorithms built from decision trees. Results We found that ESKAPE pathogens represented 42.2% of species isolated from bloodstream infections and, compared with non-ESKAPE pathogens, were associated with a 3.3-day increase in length of stay, a $5500 increase in cost of care, and a 2.1% absolute increase in mortality (P < 1e-99). ESKAPE pathogens were not universally more resistant to antibiotics, but only to select antibiotics (P < 5e-6), particularly against common empiric therapies. In addition, simple word group algorithms predicted ESKAPE pathogens with a positive predictive value of 7.9% to 56.2%, exceeding 4.8% by random guessing (P < 1e-99). Conclusions Taken together, these data highlight the pathogenicity of ESKAPE bacteria, potential mechanisms of their pathogenicity, and the potential to predict ESKAPE infections upon admission. Implementing word group algorithms could enable earlier and targeted therapies against ESKAPE bacteria and thus reduce their burden on the health care system.

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Section: Methodsmentioning

confidence: 99%

ESKAPE Pathogens in Bloodstream Infections Are Associated With Higher Cost and Mortality but Can Be Predicted Using Diagnoses Upon Admission

Marturano

Lowery

2019

Open Forum Infectious Diseases

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“…Indeed, it was estimated that, by 2025, there would be 20 million more new cases of cancer each year all over the world 2. In health system, cancer has already caused onerous burdens on both developed and developing countries 3. In China, a latest research showed that the gross incidence of cancer was about 284.55/100 000 in 2013.…”

Section: Introductionmentioning

confidence: 99%

How great is current curative expenditure and catastrophic health expenditure among patients with cancer in China? A research based on “System of Health Account 2011”

et al. 2018

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In recent years, the incidence and mortality of cancer have witnessed a dramatic increase. Cancer has already caused severe economic burdens on society, especially in developing countries and has become a major public health concern. This study evaluates the medical economic burden, including total current curative expenditure (CCE) and catastrophic health expenditure (CHE) on cancer in Liaoning Province, China. A total of 252 medical institutions were investigated with multistage stratified cluster random sampling. We established a standardized database of 3 532 517 samples. “System of Health Account 2011”, a new internationally recognized accounting system, was established to analyze the CCE on six most common cancers. CHE were estimated from the extracted 1344 patients with cancer, which performed a cross‐sectional study. The association of individual and contextual factors with CHE was evaluated using logistic regression models. CCE for all the patients with the six types of cancer was 2801.38 million CNY in Liaoning Province, the highest of which was lung cancer. The incidence of CHE was 42.78%, while the threshold was 40%. The average and relative distance were 10.41% and 24.32%, respectively. Influencing factors were length of stay, type of health insurance, location of household, etc. Our findings highlight the need to address medical economic burden in the cancer population. Households with the cancer are more likely to incur CHE. Financial intervention to prevent it should target on poor households. We provide suggestions in aspects of health insurance and health service management to reduce CHE.

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“…Apart from its high death rate, cancer is notorious for high medical costs [ 1 , 2 ]. In most cases, patients need surgery and chemotherapy, the requirement for which is usually urgent owing to the rapid progress of the disease.…”

Section: Introductionmentioning

confidence: 99%

Supporting Low-income Cancer Patients: Recommendations for the Public Financial Aid Program in the Republic of Korea

2018

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PurposeAs the recent term of “financial toxicity” implies, cancer causes a treatment-related financial harm. Financial Aid Program for Cancer Patient (FAPCP) is a government’s financial support for low-income patients in the Republic of Korea. This study aimed to describe FAPCP applicants’ condition and to investigate factors influencing financial burden, which would provide the basis for implementing a strategy for FAPCP administration.Materials and MethodsThe telephone survey results from 2,700 FAPCP participants were analyzed, including demographic, socioeconomic, and disease characteristics and experiences associated with financial burden and the actions or measures to cope with them.ResultsOverall, 87.6% experienced financial burden more than moderate degree, 39.2% got financial help/a loan, 17.8% disposed of their property, and 10.2% changed or stopped treatment owing to medical costs. Monthly household income was connected to financial burden, and the highest income group was associated with the lowest financial burden (odds ratio [OR], 0.21; 95% confidence interval [CI], 0.11 to 0.38) and the lowest rate of changing/stopping care (OR, 0.23; 95% CI, 0.05 to 1.00). Parents of childhood cancer patients got financial help/a loan (OR, 2.24; 95% CI, 1.03 to 4.88) and disposed of their property (OR, 3.18; 95% CI, 1.40 to 7.22) more frequently, and Medical Aids applicants showed the highest rate of changing/stopping care (OR, 3.01; 95% CI, 1.89 to 4.78).ConclusionFAPCP targets low income groups; however, financial burden and the consequent actions taken still exist disproportionately, depending on the income of the applicants. FAPCP should focus on more vulnerable groups including Medical Aid applicants and parents of childhood cancer patients, by increasing funds and expanding their support coverage.

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Economic burden of cancer among patients with surgical resections of the lung, rectum, liver and uterus: results from a US hospital database claims analysis

Cited by 8 publications

References 16 publications

ESKAPE Pathogens in Bloodstream Infections Are Associated With Higher Cost and Mortality but Can Be Predicted Using Diagnoses Upon Admission

ESKAPE Pathogens in Bloodstream Infections Are Associated With Higher Cost and Mortality but Can Be Predicted Using Diagnoses Upon Admission

How great is current curative expenditure and catastrophic health expenditure among patients with cancer in China? A research based on “System of Health Account 2011”

Supporting Low-income Cancer Patients: Recommendations for the Public Financial Aid Program in the Republic of Korea

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