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Healthcare utilization and spending among older patients diagnosed with Non-Hodgkin lymphoma.
- Source :
-
Journal of geriatric oncology [J Geriatr Oncol] 2021 Nov; Vol. 12 (8), pp. 1225-1232. Date of Electronic Publication: 2021 Jun 25. - Publication Year :
- 2021
-
Abstract
- Background: Developing appropriate care models for patients diagnosed with non-Hodgkin lymphoma (NHL) >65y require examination of current healthcare utilization patterns and cost, but non-malignant condition-specific utilization and Medicare spending among older patients has not been characterized.<br />Methods: Using SEER-Medicare, 14,533 patients diagnosed with NHL at age > 65 between 2008 and 2015 and a comparable non-cancer cohort (n = 14,533) were identified. Hospitalizations and outpatient visits for 109 non-malignant conditions were grouped into ten categories, allowing condition-specific utilization and spending calculation from diagnosis to 5y, censoring at blood or marrow transplantation, 6mo prior to death or end (12/31/2016). Using the 90th percentile as a cut-off, factors associated with high-hospitalization rates and high-spending were evaluated.<br />Results: Patients with NHL were 1.5-fold more likely to be hospitalized and 1.8-fold more likely to experience outpatient visits when compared with the non-cancer cohort. Patients with NHL had greater aging-related, cardiovascular, and gastrointestinal hospitalizations than controls (p < 0.001). Average Medicare spending/visit was higher for patients with NHL (hospitalization: $16,950 vs. $13,474, p < 0.001; outpatient: $1176 vs. $392, p < 0.001). Factors associated with high-utilization and high-spending included diffuse large B cell lymphoma subtype, non-white race, and residence in low-education area.<br />Conclusions: Older patients with NHL experienced higher utilization and higher spending per-utilization compared to a non-cancer cohort over five years from cancer diagnosis. Clinical and demographic sub-groups demonstrated increased risk for the highest spending and utilization. The substantial utilization and spending for non-malignant conditions among older patients with NHL provides quantifiable evidence for survivor-adapted healthcare management policies.<br />Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to report.<br /> (Copyright © 2021 Elsevier Ltd. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1879-4076
- Volume :
- 12
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of geriatric oncology
- Publication Type :
- Academic Journal
- Accession number :
- 34176753
- Full Text :
- https://doi.org/10.1016/j.jgo.2021.06.006