Document Detail


Racial and ethnic variation in health resource use and cost for prostate cancer.
MedLine Citation:
PMID:  20151963     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To analyse the racial and ethnic variation in health resource use (HRU) and direct medical care (DMC) cost in elderly men with prostate cancer. PATIENTS AND METHODS: This was a retrospective case-control study using the linked Surveillance, Epidemiology, and End Results Medicare database. Patients with prostate cancer diagnosed between 1995 and 1998 (50 147 men) were identified and followed retrospectively for 1 year before and 5 years after the diagnosis. Phase-specific HRU and DMC costs were compared between racial and ethnic groups using parametric and nonparametric analysis. To compute the incremental cost of prostate cancer, a matched non-cancer control group was extracted from Medicare database. Poisson and general linear models (log-link) were used to identify the association of race and ethnicity with HRU and DMC cost, after controlling for potentially influential clinical and demographic covariates. RESULTS: The African-American group was more likely to have emergency-room visits (odds ratio 1.19, 95% confidence interval 1.12-1.28) and less likely to have outpatient visits (0.96, 0.96-0.97) than whites. However, the Hispanic group was more likely to have inpatient and outpatient visits (odds ratio 0.88, 0.83-0.91; and 0.93, 0.91-0.95) than whites. Adjusted DMC cost showed racial and ethnic variation in all phases except the treatment and terminal phases. Factors associated with DMC cost varied among racial and ethnic groups. CONCLUSION: The incremental burden of prostate cancer remains significant in the long term. Overall, the cost of prostate cancer care was higher among African-American men than white and Hispanic men. This indicates the need for further research on care-level factors to comprehend the racial and ethnic disparity in HRU and cost.
Authors:
Ravishankar Jayadevappa; S Bruce Malkowicz; Sumedha Chhatre; Joseph Gallo; J Sanford Schwartz
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-02-11
Journal Detail:
Title:  BJU international     Volume:  106     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-27     Completed Date:  2010-10-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  801-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, 19104-2676, USA. jravi@mail.med.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Epidemiologic Methods
Ethnic Groups / statistics & numerical data*
Health Care Costs / statistics & numerical data*
Health Resources / economics,  statistics & numerical data*
Health Services Needs and Demand / economics,  statistics & numerical data*
Humans
Male
Prostatic Neoplasms / economics,  ethnology*,  therapy
SEER Program
United States / ethnology
Grant Support
ID/Acronym/Agency:
5R03CA 121338-2/CA/NCI NIH HHS

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