The Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement

Yabroff, K. Robin; Dowling, Emily C.; Rodriguez, Juan L.; Ekwueme, Donatus U.; Meissner, Helen I.; Soni, Anita; Lerro, Catherine C.; Willis, Gordon; Forsythe, Laura P.; Borowski, Laurel A.; Virgo, Katherine S.

doi:10.1007/s11764-012-0221-2

Cited by 86 publications

(105 citation statements)

References 30 publications

(43 reference statements)

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“…In this study, we applied a medical service-based approach for estimating annual patient time costs associated with medical care among cancer survivors in a nationally representative sample of adults of all ages in the U.S. Because the MEPS contains comprehensive information about utilization, employment, and expenditures and the forthcoming MEPS Experiences with Cancer Survivorship Supplement (24) contains questions focused on cancer survivorship, our annual patient time cost estimates can be compared with other estimates of direct medical (6;9) and indirect productivity costs (9) associated with cancer for a more complete understanding of differences in burden of illness. Our time cost estimates can also be used as inputs for cost-effectiveness analyses of interventions aimed at improving care for cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

Annual Patient Time Costs Associated With Medical Care Among Cancer Survivors in the United States

et al. 2014

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Background Although patient time costs are recommended for inclusion in cost-effectiveness analyses, these data are not routinely collected. We used nationally representative data and a medical service-based approach to estimate annual patient time costs among cancer survivors. Methods We identified 6,699 cancer survivors and 86,412 individuals without a cancer history ≥ 18 years from the 2008–2011 Medical Expenditure Panel Survey (MEPS). Service use was categorized as hospitalizations, emergency room (ER) use, provider visits, ambulatory surgery, chemotherapy, and radiation therapy. Service time estimates were applied to frequencies for each service category and the U.S. median wage rate in 2011 was used to value time. We evaluated the association between cancer survivorship and service use frequencies and patient time costs with multivariable regression models, stratified by age group (18–64 and 65+ years). Sensitivity analyses evaluated different approaches for valuing time. Results Cancer survivors were more likely to have hospitalizations, ER visits, ambulatory surgeries, and provider visits in the past year than individuals without a cancer history in adjusted analyses (p<0.05). Annual patient time was higher for cancer survivors than individuals without a cancer history among those ages 18–64 (30.2 vs. 13.6 hours; p<0.001) and ages 65+ (55.1 vs. 36.6 hours; p<0.001), as were annual patient time costs (18–64 years: $500 vs. $226; p<0.001 and 65+ years: $913 vs. $607; p<0.001). Conclusions Cancer survivors had greater annual medical service use and patient time costs than individuals without a cancer history. This medical service-based approach for estimating annual time costs can also be applied to other conditions.

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Section: Discussionmentioning

confidence: 99%

Annual Patient Time Costs Associated With Medical Care Among Cancer Survivors in the United States

et al. 2014

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“…MEPS-HC includes individuals of all ages, with all insurance types, and collects information on sociodemographic and health characteristics, as well as medical expenditures and service use [21]. In 2011, cancer survivors identified in NHIS were oversampled and completed the ECSS—a self-administered questionnaire co-developed by the National Cancer Institute (NCI), American Cancer Society (ACS), Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and LIVESTRONG—to provide national estimates of psychosocial, financial, work-related, and other aspects of cancer burden [20, 22]. Response rates for the 2011 MEPS-HC and ECSS were 59.4 and 91 %, respectively [23, 24].…”

Section: Methodsmentioning

confidence: 99%

“…The recently released Experiences with Cancer Survivorship Supplement to the Medical Expenditure Panel Survey offers a unique opportunity to improve our knowledge about the overall burden experienced by cancer survivors in the USA [20]. To address gaps in existing literature, we take advantage of these newly available data to examine work and financial burden as reported by cancer survivors in a large, nationally representative sample that included survivors of all cancer types.…”

Section: Introductionmentioning

confidence: 99%

Predictors of financial difficulties and work modifications among cancer survivors in the United States

et al. 2015

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Purpose The aim of this study is to examine predictors of cancer-related financial difficulties and work modifications in a national sample of cancer survivors. Methods Using the 2011 Medical Expenditure Panel Survey and Experiences with Cancer Survivorship Supplement, the prevalence of financial difficulties and work modifications was examined. Logistic regression and survey weights were used to model these outcomes as functions of sociodemographic and health covariates separately among survivors in active treatment and survivors under age 65 years. Results Among all survivors, 33.2 % reported any financial concern, with 17.9 % reporting financial difficulties such as debt or bankruptcy. Among working survivors, 44.0 % made any work modification and 15.3 % made long-term work modifications (e.g., delayed or early retirement). Among those in active treatment, predictors of financial difficulty included: race/ethnicity other than white, non-Hispanic [OR=8.0; 95 % CI 2.2–28.4]; income <200 % of federal poverty level (FPL) [OR=15.7; 95 % CI 2.6–95.2] or between 200 and 400 % of FPL [OR=8.2; 95 % CI 1.3–51.4]; residence in a non-metropolitan service area [OR=6.4; 95 % CI 1.6–25.0]; and good/fair/poor self-rated health [OR=3.8; 95 % CI 1.0–14.2]. Among survivors under age 65 years, predictors of long-term work modifications included good/fair/poor self-rated health [OR=4.1; 95 % CI 1.6–10.2], being married [OR=2.2; 95 % CI 1.0–4.7], uninsured [OR=3.5; 95 % CI 1.3–9.3], or publicly insured [OR=9.0; 95 % CI 3.3–24.4]. Conclusions A substantial proportion of cancer survivors experience cancer-related financial difficulties and work modifications, particularly those who report race/ethnicity other than white, non-Hispanic, residence in non-metropolitan areas, worse health status, lower income, and public or no health insurance. Implications for cancer survivors Attention to the economic impact of cancer treatment is warranted across the survivorship trajectory, with particular attention to subgroups at higher risk.

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“…3 Through a new collaborative effort, the MEPS Experiences With Cancer Survivorship Supplement promises to address these key gaps in cancer survivorship research by providing important information to help improve the quality of the cancer survivorship experience and reduce the burden of cancer in the United States. 42 In summary, the economic burden of cancer survivorship is substantial, resulting in excess health care expenditures and lost productivity costs among survivors compared with individuals without a history of cancer. The economic impact of cancer is considerable and long lasting.…”

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confidence: 99%

Economic Burden of Cancer Survivorship Among Adults in the United States

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Ekwueme

Yabroff

et al. 2013

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MethodsUsing the 2008 to 2010 Medical Expenditure Panel Survey, we identified 4,960 cancer survivors and 64,431 individuals without a history of cancer age Ն 18 years. Direct medical costs were measured using annual health care expenditures and examined by source of payment and service type. Indirect morbidity costs were estimated from lost productivity as a result of employment disability, missed work days, and lost household productivity. We evaluated the economic burden of cancer survivorship by estimating excess costs among cancer survivors, stratified by time since diagnosis (recently diagnosed [Յ 1 year] and previously diagnosed [Ͼ 1 year]), compared with individuals without a history of cancer using multivariable regression models stratified by age (18 to 64 and Ն 65 years), controlling for age, sex, race/ethnicity, education, and comorbidities.

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The Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement

Abstract: Research using the MEPS Experiences with Cancer Survivorship Supplement can inform efforts by health care policy makers, healthcare systems, providers, and employers to improve the cancer survivorship experience in the USA.

Cited by 86 publications

References 30 publications

Annual Patient Time Costs Associated With Medical Care Among Cancer Survivors in the United States

Annual Patient Time Costs Associated With Medical Care Among Cancer Survivors in the United States

Predictors of financial difficulties and work modifications among cancer survivors in the United States

Economic Burden of Cancer Survivorship Among Adults in the United States

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