Relationship between quality of comorbid condition care and costs for cancer survivors

Kevin Frick, Claire Snyder, Robert J. Herbert, Amanda L. Blackford, Bridget A. Neville, Antonio C Wolff, Michael A Carducci, Craig C. Earle

Research output: Contribution to journalArticle

Abstract

Purpose Toestimate the association between cancer survivors' comorbid condition care quality and costs; to determine whether the association differs between cancer survivors and other patients. Methods Using the SEER-Medicare-linked database, we identified survivors of breast, prostate, and colorectal cancers who were diagnosed in 2004, enrolled in Medicare fee-for-service for at least 12 months before diagnosis, and survived $ 3 years. Quality of care was assessed using nine process indicators for chronic conditions, and a composite indicator representing seven avoidable outcomes. Total costs on the basis of Medicare amount paid were grouped as inpatient and outpatient. We examined the association between care quality and costs for cancer survivors, and compared this associationamong2:1 frequency matched noncancer controls, using comparisons of means and generalized linear regressions. Results Our sample included 8,661 cancer survivors and 17,332 matched noncancer controls. Receipt of recommended care was associated with higher outpatient costs for eight indicators, and higher inpatient and total costs for five indicators. For three measures (visit every 6 months for patients with chronic obstructive pulmonary disease or diabetes, and glycosylated hemoglobin or fructosamine every 6 months for patients with diabetes), costs for cancer survivors who received recommended care increased less than for noncancer controls. The absence of avoidable events was associated with lower costs of each type. An annual eye examination for patients with diabetes was associated with lower inpatient costs. Conclusion Higher-quality processes of care may not reduce short-term costs, but the prevention of avoidable outcomes reduces costs. The association between quality and cost was similar for cancer survivors and noncancer controls.

Original languageEnglish (US)
Pages (from-to)e734-e745
JournalJournal of Oncology Practice
Volume12
Issue number6
DOIs
StatePublished - Jun 1 2016

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Survivors
Costs and Cost Analysis
Neoplasms
Quality of Health Care
Medicare
Inpatients
Outpatients
Fructosamine
Fee-for-Service Plans
Glycosylated Hemoglobin A
Chronic Obstructive Pulmonary Disease
Colorectal Neoplasms
Linear Models
Prostatic Neoplasms
Databases
Breast Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy

Cite this

Relationship between quality of comorbid condition care and costs for cancer survivors. / Frick, Kevin; Snyder, Claire; Herbert, Robert J.; Blackford, Amanda L.; Neville, Bridget A.; Wolff, Antonio C; Carducci, Michael A; Earle, Craig C.

In: Journal of Oncology Practice, Vol. 12, No. 6, 01.06.2016, p. e734-e745.

Research output: Contribution to journalArticle

Frick, Kevin ; Snyder, Claire ; Herbert, Robert J. ; Blackford, Amanda L. ; Neville, Bridget A. ; Wolff, Antonio C ; Carducci, Michael A ; Earle, Craig C. / Relationship between quality of comorbid condition care and costs for cancer survivors. In: Journal of Oncology Practice. 2016 ; Vol. 12, No. 6. pp. e734-e745.
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