Cost and Utilization of Lung Cancer End-of-Life Care Among Racial-Ethnic Minority Groups in the United States

Chen, Yufan; Criss, Steven D.; Watson, Tina R.; Eckel, Andrew; Palazzo, Lauren; Tramontano, Angela C.; Wang, Ying; Mercaldo, Nathaniel D.; Kong, Chung Yin

doi:10.1634/theoncologist.2019-0303

Cited by 27 publications

(23 citation statements)

References 32 publications

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“…In most nations, lung cancer is the primary reason for cancer-caused disability-adjusted life years (DALYs) (1,2). Patients with lung cancer face considerable medical costs and service utilization (3)(4)(5). The financial burden on patients with lung cancer includes both direct costs and indirect expenditures, such as transportation and lost income (out of work or on sick leave) (3,6).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Financial Toxicity Among Patients With Advanced Lung Cancer in Western China

et al. 2022

Front. Public Health

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Background: Lung cancer is the leading source of cancer-caused disability-adjusted life years. Medical cost burden impacts the well-being of patients through reducing income, cutting daily expenses, curtailing leisure activities, and depleting exhausting savings. The COmprehensive Score for Financial Toxicity (COST) was created and validated by De Souza and colleagues. Our study intends to measure the financial burdens of cancer therapy and investigate the link between financial toxicity and health-related quality of life (HRQoL) in an advanced lung cancer population.Methods: Patients aged ≥ 18 years with confirmed stage III to IV lung cancer were eligible. The COST questionnaire verified by de Souza et al. was used to identify financial toxicity. Multivariable linear regression analysis with log transformation univariate analysis and Pearson correlations were used to perform the analysis.Results: The majority of the patients (90.8%, n = 138/152) had an annual income of $50,000 ($7,775). The cohort's insurance situation was as follows: 64.5% of the cohort had social insurance, 20.4% had commercial insurance, and 22.0% had both. Patients who were younger age (50–59, P < 0.001), employed but on sick leave, and had lower income reported increased levels of financial toxicity (P < 0.05). The risk factors for high financial toxicity: (i) younger age (50–59), (ii) <1 month of savings, and (iii) being employed but on sick leave. Increased financial toxicity is moderately correlated with a decrease in QoL.Conclusion: Poorer psychological status and specific demographics are linked to increased financial toxicity (lower COST). Financial toxicity has a modest relationship with HRQoL and may have a clear link with HRQoL measurements.

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Section: Introductionmentioning

confidence: 99%

Assessment of Financial Toxicity Among Patients With Advanced Lung Cancer in Western China

et al. 2022

Front. Public Health

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“…In a previous study, we determined lung cancer-related costs in the last month of life for White, Black, Asian and Hispanic patients separately and identified significant racial/ethnic cost disparities. [15] Given the known differences in colorectal cancer treatment and outcomes by race/ethnicity, we were interested in seeing whether cost disparities persisted in this context. To pinpoint where disparities might be most pronounced throughout the entire course of care, we used a large, population-based database to estimate CRC care costs by treatment phase.…”

Section: Introductionmentioning

confidence: 99%

Racial/ethnic disparities in colorectal cancer treatment utilization and phase-specific costs, 2000-2014

Tramontano¹,

Chen²,

Watson³

et al. 2020

PLoS ONE

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Background Our study analyzed disparities in utilization and phase-specific costs of care among older colorectal cancer patients in the United States. We also estimated the phase-specific costs by cancer type, stage at diagnosis, and treatment modality. Methods We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify patients aged 66 or older diagnosed with colon or rectal cancer between 2000-2013, with follow-up to death or December 31, 2014. We divided the patient's experience into separate phases of care: staging or surgery, initial, continuing, and terminal. We calculated total, cancer-attributable, and patient-liability costs. We fit logistic regression models to determine predictors of treatment receipt and fit linear regression models to determine relative costs. All costs are reported in 2019 US dollars. Results Our cohort included 90,023 colon cancer patients and 25,581 rectal cancer patients. After controlling for patient and clinical characteristics, Non-Hispanic Blacks were less likely to receive treatment but were more likely to have higher cancer-attributable costs within different phases of care. Overall, in both the colon and rectal cancer cohorts, mean monthly cost estimates were highest in the terminal phase, next highest in the staging phase, decreased in the initial phase, and were lowest in the continuing phase. Conclusions Racial/ethnic disparities in treatment utilization and costs persist among colorectal cancer patients. Additionally, colorectal cancer costs are substantial and vary widely among stages and treatment modalities. This study provides information regarding cost and treatment

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“…[15][16][17] Interpreter services positively impact communication and outcomes, increasing patient and family satisfaction with care, increasing understanding of diagnosis and treatment plans, reducing complications and length of hospital stay, and bolstering the use of preventive healthcare services. [11][12][13][18][19][20] Across the lifespan from pediatric care to end of life care, interpreters have been shown to bene t patients. [14,21] Despite evidence of the bene t of interpreters, interpreters are underused as clinicians try to "get-by" with their own limited language skills or those of family members.…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Developing an Electronic Search Strategy Algorithm for Detecting Professional Interpreter Use among Patients with Limited English Proficiency: A Derivation and Validation Study

Soleimani

Márquez

Weister

et al. 2020

Preprint

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Background Evidence exists that disparities occur for patients with Limited English Proficiency (LEP) that impact the quality of medical services, outcomes, and patient satisfaction. Using interpreter services can reduce these negative impacts; therefore optimizing our understanding of interpreter use during patient care is important. Manual chart review is time-consuming. The objective of this study was to develop and validate a search strategy algorithm to detect patients who used professional interpreter services during their hospitalization. Methods We identified all adults who were admitted to the hospital who had at least one Intensive Care Units (ICU) admission during the hospital stay across the Mayo Clinic Enterprise between January 1, 2015, and June 30, 2020. Three random subsets of 100 patients were extracted from 60,268 patients admitted to an ICU to develop the search strategy algorithm. A physician reviewer conducted the gold standard manual chart review and these results were compared with the search strategy algorithm each time it was refined. Iterative modification of the search strategy was performed and sensitivity and specificity were calculated by comparing the results to the reference standard for both derivation cohorts and the final validation cohort. Any uncertainties were resolved by a second physician researcher. Results The first search strategy resulted in a specificity of 95.7% and a sensitivity of 93.5%. The second revised search strategy achieved a specificity of 96.7% and a sensitivity of 92.3%. The final version of the search strategy was applied to the validation subset and specificity and sensitivity were 92.6% and 100% respectively. Conclusion We successfully derived and validated a search strategy algorithm to assess interpreter use among hospitalized patients. Developing a search strategy algorithm with a high sensitivity can reduce the time required to abstract data from the medical record compared to manual chart review. This can be used to examine and understand patient needs for research and quality improvement initiatives.

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Cost and Utilization of Lung Cancer End-of-Life Care Among Racial-Ethnic Minority Groups in the United States

Cited by 27 publications

References 32 publications

Assessment of Financial Toxicity Among Patients With Advanced Lung Cancer in Western China

Assessment of Financial Toxicity Among Patients With Advanced Lung Cancer in Western China

Racial/ethnic disparities in colorectal cancer treatment utilization and phase-specific costs, 2000-2014

WITHDRAWN: Developing an Electronic Search Strategy Algorithm for Detecting Professional Interpreter Use among Patients with Limited English Proficiency: A Derivation and Validation Study

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