They studied men aged >66 years with a diagnosis of prostate cancer in 2009. They next stratified men by the amount of healthcare expenditures, specifically looking at the top 5% in order to determine health care pending trends and to determine what contributes to the high costs of care for the top 5% of patients.
They identified 12,875 men with a primary diagnosis of prostate cancer in 2009. The total cost of care for these patients to the healthcare system was $241,800,495 (mean $18781 per patient). The top 5% of men required healthcare expenditures of $62,474,504, while the bottom 95% spent $179,325,991. They found that the factors that were correlated with being a top 5% expenditure patient were older age, more medical conditions at diagnosis, African-American race, and non-married. The top 5% of patients also had higher rates of metastatic disease at diagnosis as compared to the bottom 95% of patients (14% vs. 3%). On multivariate analysis, more advanced disease, unmarried men, higher Charlson comorbidity index, and those living in a higher Medicare spending health service area also were risk factors for being a top 5% expenditure patient.
They concluded that the top 5% of healthcare expenditure patients with prostate cancer in 2009 accounted for 25% of the total cost of treating this very common malignancy. Acknowledgement of the factors contributing to increased healthcare expenditures is very important in order to begin help decreasing the cost of care for prostate cancer, which is the most common soft tissue malignancy in American men.
Presented by: Maxine Sun, Boston MA
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