Out-of-Pocket Health-Care Expenditures among Older Americans with Cancer
dc.contributor.author | Langa, Kenneth M. | en_US |
dc.contributor.author | Fendrick, A. Mark | en_US |
dc.contributor.author | Chernew, Michael E. | en_US |
dc.contributor.author | Kabeto, Mohammed U. | en_US |
dc.contributor.author | Paisley, Kerry L. | en_US |
dc.contributor.author | Hayman, James A. | en_US |
dc.date.accessioned | 2010-06-01T20:30:02Z | |
dc.date.available | 2010-06-01T20:30:02Z | |
dc.date.issued | 2004-03 | en_US |
dc.identifier.citation | Langa, Kenneth M.; Fendrick, A. Mark; Chernew, Michael E.; Kabeto, Mohammed U.; Paisley, Kerry L.; Hayman, James A. (2004). "Out-of-Pocket Health-Care Expenditures among Older Americans with Cancer." Value in Health 7(2): 186-194. <http://hdl.handle.net/2027.42/73612> | en_US |
dc.identifier.issn | 1098-3015 | en_US |
dc.identifier.issn | 1524-4733 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/73612 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=15164808&dopt=citation | en_US |
dc.description.abstract | Objective: There is currently limited information regarding the out-of-pocket expenditures (OOPE) for medical care made by elderly individuals with cancer. We sought to quantify OOPE for community-dwelling individuals age 70 or older with: 1) no cancer (No CA), 2) a history of cancer, not undergoing current treatment (CA/No Tx), and 3) a history of cancer, undergoing current treatment (CA/Tx). Methods: We used data from the 1995 Asset and Health Dynamics Study, a nationally representative survey of community-dwelling elderly individuals. Respondents identified their cancer status and reported OOPE for the prior 2 years for: 1) hospital and nursing home stays, 2) outpatient services, 3) home care, and 4) prescription medications. Using a multivariable two-part regression model to control for differences in sociodemographics, living situation, functional limitations, comorbid chronic conditions, and insurance coverage, the additional cancer-related OOPE were estimated. Results: Of the 6370 respondents, 5382 (84%) reported No CA, 812 (13%) reported CA/No Tx, and 176 (3%) reported CA/Tx. The adjusted mean annual OOPE for the No CA, CA/No Tx, and CA/Tx groups were $1210, $1450, and $1880, respectively ( P < .01). Prescription medications ($1120 per year) and home care services ($250) accounted for most of the additional OOPE associated with cancer treatment. Low-income individuals undergoing cancer treatment spent about 27% of their yearly income on OOPE compared to only 5% of yearly income for high-income individuals with no cancer history ( P < .01). Conclusions: Cancer treatment in older individuals results in significant OOPE, mainly for prescription medications and home care services. Economic evaluations and public policies aimed at cancer prevention and treatment should take note of the significant OOPE made by older Americans with cancer. | en_US |
dc.format.extent | 113035 bytes | |
dc.format.extent | 3109 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Blackwell Science Inc | en_US |
dc.rights | ISPOR | en_US |
dc.subject.other | Cancer | en_US |
dc.subject.other | Cost of Illness | en_US |
dc.subject.other | Elderly | en_US |
dc.subject.other | Health-care Expenditures | en_US |
dc.subject.other | Health Economics | en_US |
dc.title | Out-of-Pocket Health-Care Expenditures among Older Americans with Cancer | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Medicine (General) | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of General Medicine Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; | en_US |
dc.contributor.affiliationum | Institute for Social Research, University of Michigan, Ann Arbor, MI, USA; | en_US |
dc.contributor.affiliationum | Patient Safety Enhancement Program, University of Michigan Health System, Ann Arbor, MI, USA; | en_US |
dc.contributor.affiliationum | Consortium for Health Outcomes, Innovation, and Cost-Effectiveness Studies (CHOICES), University of Michigan, Ann Arbor, MI, USA; | en_US |
dc.contributor.affiliationum | Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA; | en_US |
dc.contributor.affiliationum | Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA | en_US |
dc.contributor.affiliationother | Department of Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, MI, USA; | en_US |
dc.identifier.pmid | 15164808 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/73612/1/j.1524-4733.2004.72334.x.pdf | |
dc.identifier.doi | 10.1111/j.1524-4733.2004.72334.x | en_US |
dc.identifier.source | Value in Health | en_US |
dc.identifier.citedreference | Gross D, Brangan N. Out-of-pocket spending on health care by Medicare beneficiaries age 65 and older: 1999 projections. Issue Brief (Public Policy Inst (Am Assoc Retired Pers) 1999: 1 – 14. | en_US |
dc.identifier.citedreference | Crystal S, Johnson R, Harman J, Sambamoorthi U, Kumar R. Out-of-pocket health care costs among older Americans. J Gerontol Social Sci 2000; 55B: S51 – 62. | en_US |
dc.identifier.citedreference | Hwang W, Weller W, Ireys H, Anderson G. Out-of-pocket medical spending for care of chronic conditions. Health Aff 2001; 20: 267 – 78. | en_US |
dc.identifier.citedreference | Cassel CK, Besdine RW, Siegel LC. Restructuring Medicare for the next century: what will beneficiaries really need? Health Aff 1999; 18: 118 – 31. | en_US |
dc.identifier.citedreference | Soumerai S, Ross-Degnan D. Inadequate prescription-drug coverage for Medicare enrollees—a call to action. N Engl J Med 1999; 340: 722 – 8. | en_US |
dc.identifier.citedreference | Altman BM, Cooper PF, Cunningham PJ. The case of disability in the family: impact on health care utilization and expenditures for nondisabled members. Milbank Q 1999; 77: 39 – 75. | en_US |
dc.identifier.citedreference | Federman AD, Adams AS, Ross-Degnan D, et al. Supplemental insurance and use of effective cardiovascular drugs among elderly medicare beneficiaries with coronary heart disease. JAMA 2001; 286: 1732 – 9. | en_US |
dc.identifier.citedreference | Steinman M, Sands L, Covinsky K. Self-restriction of medications due to cost in seniors without prescription coverage. J Gen Intern Med 2001; 16: 793 – 9. | en_US |
dc.identifier.citedreference | Fendrick A, Smith D, Chernew M, Shah S. A benefit-based copay for prescription drugs. patient contribution based on total benefits, not drug acquisition cost. Am J Manag Care 2001; 7: 861 – 7. | en_US |
dc.identifier.citedreference | Gross D, Alecxih L, Gibson M, et al. Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries. Health Serv Res 1999; 34: 241 – 54. | en_US |
dc.identifier.citedreference | Hoffman C, Rice D, Sung H. Persons with chronic conditions: their prevalence and costs. JAMA 1996; 276: 1473 – 9. | en_US |
dc.identifier.citedreference | Brookmeyer R, Gray S, Kawas C. Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. Am J Public Health 1998; 88: 1337 – 42. | en_US |
dc.identifier.citedreference | Kramarow E, Lentzner H, Rooks R, et al. Health and Aging Chartbook: Health, United States, 1999. Hyattsville (MD): National Center for Health Statistics, 1999. | en_US |
dc.identifier.citedreference | Yancik R, Ries LA. Aging and cancer in America: demographic and epidemiologic perspectives. Hematol Oncol Clin North Am 2000; 14: 17 – 23. | en_US |
dc.identifier.citedreference | Kirschstein R. Disease-Specific Estimates of Direct and Indirect Costs of Illness and NIH Support [Internet]. Bethesda: NIH; 2000 [accessed 2003 Jan 23]. Available from: http://www1.od.nih.gov/osp/ospp/ecostudies/COIreportweb.htm. | en_US |
dc.identifier.citedreference | Hartunian NS, Smart CN, Thompson MS. The incidence and economic costs of cancer, motor vehicle injuries, coronary heart disease, and stroke: a comparative analysis. Am J Public Health 1980; 70: 1249 – 60. | en_US |
dc.identifier.citedreference | Houts PS, Lipton A, Harvey HA, et al. Nonmedical costs to patients and their families associated with outpatient chemotherapy. Cancer 1984; 53: 2388 – 92. | en_US |
dc.identifier.citedreference | Spector WD, Mor V. Utilization and charges for terminal cancer patients in Rhode Island. Inquiry 1984; 21: 328 – 37. | en_US |
dc.identifier.citedreference | Brown ML. The national economic burden of cancer: an update. J Natl Cancer Inst 1990; 82: 1811 – 4. | en_US |
dc.identifier.citedreference | Baker MS, Kessler LG, Urban N, Smucker RC. Estimating the treatment costs of breast and lung cancer. Med Care 1991; 29: 40 – 9. | en_US |
dc.identifier.citedreference | Bried EM, Scheffler RM. The financial stages of cancer in the elderly. Oncology (Huntingt) 1992; 6: 153 – 60. | en_US |
dc.identifier.citedreference | Riley GF, Potosky AL, Lubitz JD, Kessler LG. Medicare payments from diagnosis to death for elderly cancer patients by stage at diagnosis. Med Care 1995; 33: 828 – 41. | en_US |
dc.identifier.citedreference | Taplin SH, Barlow W, Urban N, et al. Stage, age, comorbidity, and direct costs of colon, prostate, and breast cancer care. J Natl Cancer Inst 1995; 87: 417 – 26. | en_US |
dc.identifier.citedreference | Legorreta AP, Brooks RJ, Leibowitz AN, Solin LJ. Cost of breast cancer treatment: a 4-year longitudinal study. Arch Intern Med 1996; 156: 2197 – 201. | en_US |
dc.identifier.citedreference | Fireman BH, Quesenberry CP, Somkin CP, et al. Cost of care for cancer in a health maintenance organization. Health Care Financ Rev 1997; 18: 51 – 76. | en_US |
dc.identifier.citedreference | Brown ML, Riley GF, Potosky AL, Etzioni RD. Obtaining long-term disease specific costs of care: application to Medicare enrollees diagnosed with colorectal cancer. Med Care 1999; 37: 1249 – 59. | en_US |
dc.identifier.citedreference | Bloom BS, Knorr RS, Evans AE. The epidemiology of disease expenses. JAMA 1985; 253: 2393 – 7. | en_US |
dc.identifier.citedreference | Stommel M, Given CW, Given BA. The cost of cancer home care to families. Cancer 1993; 71: 1867 – 74. | en_US |
dc.identifier.citedreference | Given BA, Given CW, Stommel M. Family and out-of-pocket costs for women with breast cancer. Cancer Pract 1994; 2: 187 – 93. | en_US |
dc.identifier.citedreference | Close P, Burkey E, Kazak A, et al. A prospective, controlled evaluation of home chemotherapy for children with cancer. Pediatrics 1995; 95: 896 – 900. | en_US |
dc.identifier.citedreference | Guidry JJ, Aday LA, Zhang D, Winn RJ. Cost considerations as potential barriers to cancer treatment. Cancer Pract 1998; 6: 182 – 7. | en_US |
dc.identifier.citedreference | Aubert R, Herman W, Waters J, et al. Nurse case management to improve glycemic control in diabetic patients in a health maintenance organization: a randomized controlled trial. Ann Intern Med 1998; 129: 605 – 12. | en_US |
dc.identifier.citedreference | Wilson RS, Beckett LA, Bennett DA, et al. Change in cognitive function in older persons from a community population: relation to age and Alzheimer disease. Arch Neurol 1999; 56: 1274 – 9. | en_US |
dc.identifier.citedreference | Moore KA. Breast cancer patients’ out-of-pocket expenses. Cancer Nurs 1999; 22: 389 – 96. | en_US |
dc.identifier.citedreference | Soldo BJ, Hurd MD, Rodgers WL, Wallace RB. Asset and health dynamics among the oldest old: an overview of the AHEAD Study. J Gerontol Psychol Sci Soc Sci 1997; 52B: 1 – 20. | en_US |
dc.identifier.citedreference | Heeringa S, Hill DH, Howell D. Unfolding Brackets for Reducing Item Nonresponse in Economic Surveys. Health and Retirement Study Working Paper Series, No. 94–029. Ann Arbor: Survey Research Center, Institute for Social Research, The University of Michigan, 1995. | en_US |
dc.identifier.citedreference | Cao H. Impute: A SAS Application System for Missing Value Imputations [Internet]. Ann Arbor: Survey Research Center, Institute for Social Research, The University of Michigan, 2001 [last accessed 2003 Jan 23]. Available from: http://www.umich.edu/~hrswww/docs/userg/dr-007.pdf. | en_US |
dc.identifier.citedreference | Brandt J, Spencer M, Folstein M. The telephone interview for cognitive status. Neuropsychiatry Neuropsychol Behav Neurol 1988; 1: 111 – 7. | en_US |
dc.identifier.citedreference | Langa K, Chernew M, Kabeto MU, et al. National estimates of the quantity and cost of informal caregiving for the elderly with dementia. J Gen Intern Med 2001; 16: 770 – 8. | en_US |
dc.identifier.citedreference | Duan N, Manning WG, Morris CN, Newhouse JP. A comparison of alternative models for the demand for medical care. J Bus Econ Stat 1983; 1: 115 – 26. | en_US |
dc.identifier.citedreference | Manning WG. The logged dependent variable, heteroscedasticity, and the retransformation problem. J Health Econ 1998; 17: 283 – 95. | en_US |
dc.identifier.citedreference | 42 Centers for Medicare and Medicaid Services. Medicare Deductible, Coinsurance and Premium Amounts, 2001 [Internet]. Baltimore: The Centers, 2004. Available from: http://custhelp.medicare.com/cgi-bin/medicare.cfg/php/enduser/std_alp.php. | en_US |
dc.identifier.citedreference | 43 National Cancer Institute. Overview of Cancer Prevalence Statistics [Internet]. Bethesda: The Institute, c2004 [last accessed 2003 Jan 23]. Available from: http://srab.cancer.gov/prevalence. | en_US |
dc.identifier.citedreference | Eppig F, Chulis G. Matching MCBS (Medicare Current Beneficiary Survey) and Medicare data: the best of both worlds. Health Care Financ Rev 1997; 18: 211 – 29. | en_US |
dc.identifier.citedreference | Thomas C, Ritter G, Wallack S. Growth in prescription drug spending among insured elders. Health Aff (Millwood) 2001; 20: 265 – 77. | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.