Out-of-Pocket Health-Care Expenditures among Older Americans with Cancer

Langa, Kenneth M.; Fendrick, A. Mark; Chernew, Michael E.; Kabeto, Mohammed U.; Paisley, Kerry L; Hayman, James A.

doi:10.1111/j.1524-4733.2004.72334.x

Cited by 120 publications

(94 citation statements)

References 32 publications

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“…According to statistics of the NHI claims, the inpatient care performance for patients diagnosed with neoplasm (C00-D48) increased as follows: the number of patients increased from 331,055 in 2004 to 506,311 in 2010, the LOS increased from 11,393,760 in 2004 to 19,628,508 455,943/2,900 3,742,432/3,269 3,947,331/3,854 3,810,849/3,988 3,736,173/4,021 3,848,233/3,490 3,882,147/3,041 4,068,954/3,519 Considering that the subjective economic burden for medical expenditures is larger for elderly individuals, the unemployed, and those with a higher proportion of medical expenditures among household expenditures (Choi et al, 2011), patients' subjective economic burden is especially great for cancer patients. The medical expenses incurred by cancer that are the responsibility of patients are relatively high compared to the expenses caused by other diseases (Langa et al, 2004;Wagner and Lacey, 2004). A co-payment without consideration of individual income along with medical expenditures caused by uncovered services is a significant burden, especially for the elderly and low income patients with cancer, and this could influence the application of appropriate treatment methods and outcomes (Kim, 2007;Mathews et al, 2009;Neumann et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Time Trend of Out-of-pocket Expenditure among Cancer Inpatients: Evidence from Korean Tertiary Hospitals

You¹,

Kang²,

Kwon³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 99%

Time Trend of Out-of-pocket Expenditure among Cancer Inpatients: Evidence from Korean Tertiary Hospitals

You¹,

Kang²,

Kwon³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…In addition to time costs associated with informal caregiving for cancer patients, families may also experience other financial burdens related to out of pocket costs of medical care 30,31 and reduced participation in the workforce. 32 Because health insurance is commonly tied to employment in the United States, changes in employment may introduce additional challenges to the families of cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Time costs associated with informal caregiving for cancer survivors

Yabroff¹,

Kim²

2009

Cancer

262

216

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BACKGROUND:To the authors' knowledge, little work has been done to estimate the time costs associated with informal caregiving for cancer survivors.METHODS:Data from a national survey of caregivers of cancer patients in 2003 to 2006 were used to estimate the time associated with informal caregiving in the 2 years after patient diagnosis with bladder, breast, colorectal, kidney, lung, melanoma of the skin, ovarian, prostate, or uterine cancer, or non‐Hodgkins lymphoma (NHL). Caregivers reported the duration and daily intensity of caregiving as well as the types and frequency of support provided. The median wage rate in 2006 ($16.28) was used to value caregiver time, and other methods to value time were evaluated with sensitivity analyses.RESULTS:On average, caregivers provided care for 8.3 hours per day for 13.7 months. The number of months and daily hours spent caregiving were the highest for cancer survivors diagnosed with distant disease compared with survivors with regional or localized disease (P < .05). Approximately half of caregivers provided emotional, instrumental, tangible, or medical support, although the frequency varied dramatically. Informal caregiver time costs over the 2‐year period after diagnosis were the highest for caregivers of patients diagnosed with lung ($72,702; 95% confidence interval [95% CI], $56,814‐$88,590) and ovarian ($66,210; 95% CI, $40,750‐$91,670) cancers and NHL ($59,613; 95% CI, $43,423‐$75,803) and the lowest for caregivers of patients with breast cancer ($38,334; 95% CI, $31,442‐$45,226).CONCLUSIONS:Time spent by informal caregivers was substantial and was an important component of the burden of cancer care. Incorporation of the value of informal caregiver time will be important when evaluating the costs and benefits of cancer control interventions. Cancer 2009;115(18 suppl):4362–73. © 2009 American Cancer Society.

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“…10,11 Although several studies have focused on OOP spending in the Medicare beneficiary population [12][13][14][15][16][17] and have examined access to care among cancer survivors broadly defined, 18,19 to the best of our knowledge only 1 study to date has examined OOP spending for beneficiaries with cancer, but this relied on self-reported cancer diagnosis and treatment. 20 Furthermore, to our knowledge there is no information regarding OOP spending among Medicare beneficiaries with newly diagnosed cancer. These patients and their physicians are in the difficult process of making key treatment decisions, and there is little information concerning OOP spending associated with treatment in the context of the beneficiary's overall health care use and financial resources.…”

Section: Introductionmentioning

confidence: 99%

Out‐of‐pocket health care expenditure burden for Medicare beneficiaries with cancer

Davidoff

Erten

Shaffer

et al. 2012

Cancer

158

128

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BACKGROUND: There is increasing concern regarding the financial burden of care on cancer patients and their families. Medicare beneficiaries often have extensive comorbidities and limited financial resources, and may face substantial cost sharing even with supplemental coverage. In the current study, the authors examined out‐of‐pocket (OOP) spending and burden relative to income for Medicare beneficiaries with cancer. METHODS: This retrospective, observational study pooled data for 1997 through 2007 from the Medicare Current Beneficiary Survey linked to Medicare claims. Medicare beneficiaries with newly diagnosed cancer were selected using claims‐based diagnoses. Generalized linear models were used to estimate OOP spending. Logistic regression models identified factors associated with a high OOP burden, defined as spending > 20% of one's income during the cancer diagnosis and subsequent year. RESULTS: The cohort included 1868 beneficiaries with and 10,047 without cancer. Compared with the noncancer cohort, cancer patients were older, had more comorbidities, and were more likely to lack supplemental coverage. The mean OOP spending for cancer patients was $4727. Cancer patients faced an adjusted $976 (P < .01) incremental OOP spending. Greater than one‐quarter (28%) of beneficiaries with cancer experienced a high OOP burden compared with 16% of beneficiaries without cancer (P < .001). Supplemental insurance and higher income were found to be protective against a high OOP burden, whereas assets, comorbidity, and receipt of cancer‐directed radiation and antineoplastic therapy were associated with a higher OOP burden. CONCLUSIONS: Medicare beneficiaries with cancer face a higher OOP burden than their counterparts without cancer; some of the higher burden was explained by the higher comorbidity burden and lack of supplemental insurance noted among these patients. Financial pressures may discourage some elderly patients from pursuing treatment. Cancer 2013. © 2012 American Cancer Society.

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Out-of-Pocket Health-Care Expenditures among Older Americans with Cancer

Abstract: Cancer treatment in older individuals results in significant OOPE, mainly for prescription medications and home care services. Economic evaluations and public policies aimed at cancer prevention and treatment should take note of the significant OOPE made by older Americans with cancer.

Cited by 120 publications

References 32 publications

Time Trend of Out-of-pocket Expenditure among Cancer Inpatients: Evidence from Korean Tertiary Hospitals

Time Trend of Out-of-pocket Expenditure among Cancer Inpatients: Evidence from Korean Tertiary Hospitals

Time costs associated with informal caregiving for cancer survivors

Out‐of‐pocket health care expenditure burden for Medicare beneficiaries with cancer

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