Stage, Age, Comorbidity, and Direct Costs of Colon, Prostate, and Breast Cancer Care

Purpose: This study was conducted to evaluate the effect of stage at diagnosis, age, and level of comorbidity (presence of other illness) on the costs of treating three types of cancer among members of a health maintenance organization. Methods: Among 388 000 members enrolled anytime during 1990 and...

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Bibliographic Details
Published in:JNCI : Journal of the National Cancer Institute 1995-03, Vol.87 (6), p.417-426
Main Authors: Taplin, Stephen H., Barlow, William, Urban, Nicole, Mandelson, Margaret T., Timlin, Deborah J., Ichikawa, Laura, Nefcy, Pauline
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Aged, 80 and over
Biological and medical sciences
Breast cancer
Breast Neoplasms - economics
Breast Neoplasms - pathology
Colon cancer
Colonic Neoplasms - economics
Colonic Neoplasms - pathology
Comorbidity
Female
Health Care Costs
Health care expenditures
Health Maintenance Organizations
Humans
Male
Medical sciences
Middle Aged
Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
Neoplasm Staging
Prostate cancer
Prostatic Neoplasms - economics
Prostatic Neoplasms - pathology
Tumors
Washington
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Summary:Purpose: This study was conducted to evaluate the effect of stage at diagnosis, age, and level of comorbidity (presence of other illness) on the costs of treating three types of cancer among members of a health maintenance organization. Methods: Among 388 000 members enrolled anytime during 1990 and 1991 in Group Health Cooperative (GHC) of Puget Sound (Washington State), we estimated the total and net direct costs of medical care for colon, prostate, and breast cancers, including both incident (290, 554, and 645 patients, respectively) and prevalent (1046, 1295, and 2299 patients, respectively) cases. We summarized costs for initial, continuing, and terminal phases of care. Net costs were the difference between the costs of the care of each case subject and the average costs of the care for all enrollees without the cancer of interest who were of the same sex and in the same 5-year age group. Differences in estimated total and net costs by stage at diagnosis, age, and comorbidity were separately evaluated using multivariate regression modeling. All P values were two-sided. Comorbidity was based on a score calculated from 1988 pharmacy data. Results: Total costs of initial care increased with stage at diagnosis for colon (P=.0013) and breast (P
ISSN:0027-8874
1460-2105
DOI:10.1093/jnci/87.6.417