scholarly journals CHARACTERIZING REGIONAL VARIABILITY IN HEALTH RESOURCE UTILIZATION DURING THE DIAGNOSTIC PHASE OF LUNG CANCER ACROSS ONTARIO: A POPULATION-BASED ANALYSIS

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A1633-A1634
Author(s):  
Monica Mullin ◽  
Marlo Whitehead ◽  
M. Diane Lougheed ◽  
Micheal Brundage ◽  
Elizabeth Eisenhauer ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Resource Utilization ◽  
Population Based ◽  
Health Resource ◽  
Regional Variability ◽  
Health Resource Utilization

scholarly journals CNS Metastases in Epidermal Growth Factor Receptor Mutation–Positive Non–Small-Cell Lung Cancer: Impact on Health Resource Utilization

2018 ◽  
Vol 14 (10) ◽  
pp. e612-e620 ◽  
Author(s):  
Negar Chooback ◽  
Shilo Lefresne ◽  
Sally C. Lau ◽  
Cheryl Ho
Keyword(s):  
Lung Cancer ◽  
Resource Utilization ◽  
Growth Factor Receptor ◽  
Small Cell ◽  
Health Resource ◽  
Small Cell Lung ◽  
Cns Metastases ◽  
Health Resource Utilization ◽  
Epidermal Growth

Purpose: Patients with epidermal growth factor receptor (EGFR) mutation–positive (EGFRm) non–small-cell lung cancer commonly experience disease progression in the CNS. Here, we assess the impact of CNS disease on resource utilization and outcomes in patients who are EGFRm. Methods: We completed a retrospective review of all advanced patients who were EGFRm, referred to BC Cancer, and treated with a first- and/or second-generation EGFR tyrosine kinase inhibitor from 2010 to 2015. Baseline characteristics, systemic treatment, and CNS management were collected. We compared health resource utilization (HRU) between patients with CNS-negative disease and those with CNS metastases from the median time of CNS metastases diagnosis to death or last follow-up (9.1 months) and at 9 months preceding death or last follow-up for the CNS-negative group. Results: Four hundred ninety-nine patients were referred, of which 68% were female; 51% were of Asian ethnicity; and 57%, 37%, and 6% were exon 19, 21, or other, respectively; with a median age of 66 years. Two hundred twenty-nine (46%) of 499 patients developed CNS metastases—39% at diagnosis and 61% over the course of disease. CNS metastases were managed with surgery with or without whole-brain radiotherapy (WBRT; 13%) WBRT alone (73%), stereotactic radiosurgery with or without WBRT (5%), or no CNS-directed therapy (9%). The median time from the development of CNS metastases diagnosis to death was 9.1 months. CNS-negative patients used less HRU versus patients that were CNS-positive in the 9 months preceding death or last follow-up—in the average number of clinic visits (8.53 v 12.71, respectively; P < .001), hospitalizations (0.43 v 0.76, respectively; P < .001), CNS imaging investigations (0.52 v 2.65, respectively; P < .001), emergency room visits (0.03 v 0.14, respectively; P = .001), palliative care unit admission (8% v 10%, respectively; P = .64), and hospice admission (3% v 19%, respectively; P < .001). Conclusion: The incidence of CNS metastases in patients with EGFRm is high and associated with increased HRU. Prevention or delay of CNS metastases with newer systemic therapy options may translate into lower resource utilization.

scholarly journals 195. Economic and Clinical Burden of Respiratory Virus Infections in Allogeneic Hematopoietic Cell Transplantation Recipients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S226-S226
Author(s):  
Michael G Ison ◽  
Nelson Chao ◽  
Francisco M Marty ◽  
Seung Hyun Moon ◽  
Zhiji Zhang ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Research Study ◽  
Viral Infections ◽  
Scientific Research ◽  
Health Resource ◽  
Health Resource Utilization ◽  
Allogeneic Hct ◽  
Study Investigator ◽  
Respiratory Viral Infections ◽  
One Year

Abstract Background Respiratory viruses (RV), including respiratory syncytial virus (RSV), influenza, parainfluenza virus (PIV), and human metapneumovirus (HMPV), frequently lead to serious complications such as lower respiratory tract infections and death in allogeneic hematopoietic cell transplantation (HCT) recipients. We used a large US claims database to compare the total reimbursement (TR), health resource utilization (HRU) and clinical outcomes between HCT patients with and without RV infections (RVI). Methods We used the Decision Resources Group Real World Evidence Data Repository to identify HCT recipients with date of service for the procedure from 1/1/2012-12/31/2017. We estimated the reimbursements from submitted charges using a reimbursement to charge ratio of 0.425. We examined the study outcomes in the year following HCT in patients with and without RVI. We also used a generalized linear model to determine adjusted TR stratified by the presence or absence of any acute or chronic graft-versus-host diseases (GVHD) after adjusting for age, health plan, underlying disease, stem cell source, number of comorbidities, baseline costs, and follow-up time. Results The study included 13,363 patients, representing 22% of HCTs reported to CIBMTR for the study period, of which 1,368 (10%) were coded with an RVI in the year following HCT: 578 (4%) RSV, 687 (5%) influenza, 166 (1%) PIV, and 181 (1%) HMPV. Unadjusted median TR were $132,395 higher for any RVI ($139,439 RSV, $101,963 influenza, $185,041 PIV and $248,029 HMPV) compared to those without RVI (Table 1). Adjusted TR were significantly higher for patients with any RVI compared to patients without that infection (p&lt; .01) with or without GVHD (Figure 1). Patients with any RVI had significantly longer length of stay (LOS) for the HCT hospitalization, readmission rate and LOS after HCT hospitalization compared to patients without RVI (p&lt; 0.05) (Table 2). A significantly higher proportion of patients with any RVI had pneumonia as compared to patients without that infection, irrespective of presence of GVHD (p&lt; .0001). Table 1: Total healthcare reimbursement within one year of undergoing allogeneic HCT for patients with and without respiratory viral infections Figure 1: Adjusted total reimbursements within one year of undergoing allogeneic HCT for patients with and without respiratory viral infections Table 2: Health resource utilization within one year of undergoing allogeneic HCT for patients with and without respiratory viral infections Conclusion Allogeneic HCT patients with RVI have a significantly higher burden of TR, health resource utilization and worse clinical outcomes such as pneumonia during one year of undergoing HCT, regardless of the presence of GVHD. Disclosures Michael G. Ison, MD MS, AlloVir (Consultant) Francisco M. Marty, MD, Allovir (Consultant)Amplyx (Consultant)Ansun (Scientific Research Study Investigator)Avir (Consultant)Cidara (Scientific Research Study Investigator)F2G (Consultant, Scientific Research Study Investigator)Kyorin (Consultant)Merck (Consultant, Grant/Research Support, Scientific Research Study Investigator)New England Journal of Medicine (Other Financial or Material Support, Honorarium for Video)Regeneron (Consultant, Scientific Research Study Investigator)ReViral (Consultant)Scynexis (Scientific Research Study Investigator)Symbio (Consultant)Takeda (Scientific Research Study Investigator)United Medical (Consultant)WHISCON (Scientific Research Study Investigator) Seung Hyun Moon, MD, MPA, AlloVir (Employee, Shareholder) Zhiji Zhang, MS, AlloVir (Independent Contractor) Aastha Chandak, PhD, AlloVir (Independent Contractor)

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