Comparing Hospital-Based Resource Utilization and Costs for Prostate Cancer Patients With and Without Bone Metastases

Brian Seal, Sean D. Sullivan, Scott D. Ramsey, Carl V. Asche, Kenneth M Shermock, Syam Sarma, Erin A. Zagadailov, Eileen Farrelly, Michael Eaddy

Research output: Contribution to journalArticle

Abstract

Background: Since 2010, several new treatments for prostate cancer (PCa), which have entered the US market, are poised to have an impact on treatment approaches; however, there is a paucity of evidence with respect to treatment patterns and costs. As new treatment patterns emerge, it will be imperative to understand treatment patterns and costs of care prior to the advent of novel treatments.

Objective: As the PCa treatment landscape is evolving, this study sought to compare the hospital-based utilization and costs in two cohorts of patients with PCa: patients with bone metastases (w/BM) and patients without bone metastases (w/oBM). Comparisons were also made for patients with inpatient versus outpatient encounters.

Methods: Patients in the Premier Perspective Database, a US hospital database, between January 2006 and December 2010, treated in an inpatient or outpatient setting for PCa (International Classification of Diseases, 9th Revision [ICD-9] diagnosis codes 185, 233.4) were included. Patients were required to be ≥40 years of age with no additional cancers. Patients were put into cohorts on the basis of the presence of bone metastases (ICD-9 code 198.5 or use of zoledronic acid or pamidronate disodium). Utilization of PCa-related treatments was compared, controlling for age, race, hospital type, payer type, bed size, and admission source and type. Differences in treatments were assessed utilizing logistic regression, while differences in costs were analyzed using gamma-distributed generalized linear models with a log-link function. All costs are reported in US$ 2010.

Results: There were 23,747 hospitalizations for men w/BM (13,716 inpatient; 10,031 outpatient) and 187,708 hospitalizations (74,435 inpatient; 113,258 outpatient) for men w/oBM. The mean length of stay for men w/BM was 4 days compared with 2 days for men w/oBM (P 

Conclusion: Costs and utilization of PCa-related treatments vary on the basis of the presence of metastases and treatment setting (inpatient vs. outpatient).

Original languageEnglish (US)
Pages (from-to)547-557
Number of pages11
JournalApplied Health Economics and Health Policy
Volume12
Issue number5
DOIs
StatePublished - Sep 25 2014

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Prostatic Neoplasms
Neoplasm Metastasis
Costs and Cost Analysis
Bone and Bones
Inpatients
Outpatients
Therapeutics
pamidronate
zoledronic acid
International Classification of Diseases
Health Care Costs
Hospitalization
Hospital Bed Capacity
Databases
Resource utilization
Costs
Prostate cancer
Linear Models
Length of Stay
Logistic Models

ASJC Scopus subject areas

  • Economics and Econometrics
  • Health Policy
  • Medicine(all)

Cite this

Comparing Hospital-Based Resource Utilization and Costs for Prostate Cancer Patients With and Without Bone Metastases. / Seal, Brian; Sullivan, Sean D.; Ramsey, Scott D.; Asche, Carl V.; Shermock, Kenneth M; Sarma, Syam; Zagadailov, Erin A.; Farrelly, Eileen; Eaddy, Michael.

In: Applied Health Economics and Health Policy, Vol. 12, No. 5, 25.09.2014, p. 547-557.

Research output: Contribution to journalArticle

Seal, Brian ; Sullivan, Sean D. ; Ramsey, Scott D. ; Asche, Carl V. ; Shermock, Kenneth M ; Sarma, Syam ; Zagadailov, Erin A. ; Farrelly, Eileen ; Eaddy, Michael. / Comparing Hospital-Based Resource Utilization and Costs for Prostate Cancer Patients With and Without Bone Metastases. In: Applied Health Economics and Health Policy. 2014 ; Vol. 12, No. 5. pp. 547-557.
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AU - Seal, Brian

AU - Sullivan, Sean D.

AU - Ramsey, Scott D.

AU - Asche, Carl V.

AU - Shermock, Kenneth M

AU - Sarma, Syam

AU - Zagadailov, Erin A.

AU - Farrelly, Eileen

AU - Eaddy, Michael

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