Retrospective claims analysis of palliative care costs and survival in a U.S. metastatic renal cell (mRCC) population.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 433-433
Author(s):  
Henry J. Henk ◽  
Connie Chen ◽  
Agnes Benedict ◽  
Jane Sullivan ◽  
April Teitelbaum
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Plan ◽  
Index Date ◽  
Claims Data ◽  
Cohort Analysis ◽  
Hospital Costs ◽  
Best Supportive Care ◽  
Study Cohort ◽  
Care Costs

433 Background: Survival and costs outcomes for patients with mRCC receiving palliative or best supportive care (BSC) after stopping active therapy have been poorly characterized. This information is important to understand how resources are utilized at the end of life and to put current treatment costs into perspective. The objective of this retrospective database analysis was to examine survival and costs associated with BSC after receiving 1 or 2 lines of mRCC treatment. Methods: A retrospective cohort analysis using claims data from commercially insured or Medicare Advantage (MCR) enrollees of a large US health plan, with medical and pharmacy benefits. The study cohort consisted of patients with an index diagnosis for RCC [ICD-9-CM 189.0] from 1/1/07 to 6/30/10 initiating any of the following treatments from 30 days prior to index date through disenrollment: sunitinib, temsirolimus, sorafenib, bevacizumab, everolimus, pazopanib, cytokines. Patients were required to have a 6 mos. continuous enrollment ± index date (patients disenrolling due to death within the 6 mos. were retained). Lines of therapy (LOT) were identified based on prescription fill and administration dates, began following the last LOT and continued until disenrollment. Health care costs reported represent the health plan + patient paid amount. Results: The overall study cohort (n=274) was 73% male; mean (±SD) age 63.3 ± 11.1 yr. with the majority of patients commercially insured (80% vs 20% MCR). The majority started BSC following 1st LOT (68% vs 32%). Median survival from start of BSC was similar following 1st and 2nd LOT (126 and 118 days). The mean (median) duration of BSC after 1 LOT was 223 (114) days and 176 (109) days for 2 LOT. Total health care costs incurred during BSC averaged $50,187 ± 96,984 and $37,294 ± 51,101 and monthly costs were similar ($10,284 ± 17979) after 1 and 2 LOT, respectively. In both cases, inpatient hospital costs represented the largest proportion of these costs (47%) while outpatient costs represented 36%. Conclusions: Our study estimating BSC survival and costs in patients with mRCC based on US claims data found monthly cost of $10, 284. These estimates suggest that BSC costs are not insignificant.

scholarly journals Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andreas Niedermaier ◽  
Anna Freiberg ◽  
Daniel Tiller ◽  
Andreas Wienke ◽  
Amand Führer
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Asylum Seekers ◽  
Health Care Services ◽  
Claims Data ◽  
Care Utilization ◽  
Care Services ◽  
Outpatient Sector ◽  
Analysis Of Claims Data ◽  
Care Costs

Abstract Background Asylum seekers are a vulnerable group with special needs in health care due to their migration history and pre-, peri- and postmigratory social determinants of health. However, in Germany access to health care is restricted for asylum seekers by law and administrative regulations. Methods Using claims data generated in the billing process of health care services provided to asylum seekers, we explore their utilization of health care services in the outpatient sector. We describe the utilization of outpatient specialties, prevalences of diagnoses, prescribed drugs and other health care services, as well as total costs of health care provision. Results The estimated prevalence for visiting an ambulatory physician at least once per year was 67.5% [95%-Confidence-Interval (CI): 65.1–69.9%], with a notably higher prevalence for women than men. The diagnoses with the highest one-year prevalence were “Acute upper respiratory infections” (16.1% [14.5–18.0%]), “Abdominal and pelvic pain” (15.6% [13.9–17.4%]) and “Dorsalgia” (13.8% [12.2–15.5%]). A total of 21% of all prescriptions were for common pain killers. Women received more diagnoses across most diagnosis groups and prescribed drugs from all types than men. Less than half (45.3%) of all health care costs were generated in the outpatient sector. Conclusion The analysis of claims data held in a municipal social services office is a novel approach to gain better insight into asylum seekers’ utilization of health services on an individual level. Compared to regularly insured patients, four characteristics in health care utilization by asylum seekers were identified: low utilization of ambulatory physicians; a gender gap in almost all services, with higher utilization by women; frequent prescription of pain killers; and a low proportion of overall health care costs generated in the outpatient sector. Further research is needed to describe structural and individual factors producing these anomalies.

scholarly journals Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

2018 ◽  
Vol 11 ◽  
pp. 26 ◽  
Author(s):  
Álvaro Flórez-Tanus ◽  
Devian Parra ◽  
Josefina Zakzuk ◽  
Luis Caraballo ◽  
Nelson Alvis-Guzmán
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Resource Utilization ◽  
Health Care Costs ◽  
Claims Data ◽  
Asthma Severity ◽  
Claims Data Analysis ◽  
Care Costs

Using Claims Data to Contain Health Care Costs

1979 ◽  
pp. 32-52
Author(s):  
Richard H. Egdahl ◽  
Diana Chapman Walsh
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Claims Data ◽  
Care Costs

Excess Health Care Costs of Obesity in Adults with Diabetes Mellitus: a Claims Data Analysis

2010 ◽  
Vol 118 (08) ◽  
pp. 496-504 ◽  
Author(s):  
T. von Lengerke ◽  
E.-G. Hagenmeyer ◽  
H. Gothe ◽  
G. Schiffhorst ◽  
M. Happich ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Data Analysis ◽  
Health Care Costs ◽  
Claims Data ◽  
Claims Data Analysis ◽  
Care Costs

scholarly journals Treatment patterns of patients diagnosed with major headache disorders: A retrospective claims analysis

2020 ◽  
Vol 3 ◽  
pp. 251581632091399
Author(s):  
David Kudrow ◽  
Sagar Munjal ◽  
Leah Bensimon ◽  
Tasneem Lokhandwala ◽  
Binglin Yue ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Index Date ◽  
Primary Headache ◽  
Headache Disorder ◽  
Patient Characteristics ◽  
Treatment Patterns ◽  
Headache Disorders ◽  
Headache Type ◽  
Care Costs

Objective: To describe patient characteristics, treatment patterns, and health care costs among patients diagnosed with major headache disorders overall and by type (tension-type headache [TTH], migraine, cluster headache [CH], or >1 primary headache type), and secondarily to evaluate drug treatment patterns among triptan initiators with a major headache diagnosis. Methods: Using US claims data from January 2012 through December 2017, we identified adults with evidence of a major headache disorder: TTH, migraine, or CH; the first diagnosis date was deemed the index date. To evaluate triptan use specifically, patients who initiated triptans were identified; the first triptan claim date was deemed the index date. Patient characteristics, treatment patterns (concomitant treatments, adherence, number of fills), and annual health care costs data were obtained. Results: Of the 418,779 patients diagnosed with major headache disorders, the following 4 cohorts were created: TTH (8%), migraine (87%), CH (1%), and >1 primary headache type (4%). The majority used analgesic (54–73%) and psychotropic (57–81%) drugs, primarily opioids (36–53%). Headache-related costs accounted for one-fifth of all-cause costs. Of the 229,946 patients who initiated triptans, the following 7 study cohorts were analyzed: sumatriptan (68%), rizatriptan (21%), eletriptan (5%), zolmitriptan (3%), naratriptan (2%), frovatriptan (1%), and almotriptan (<1%). The major concomitant analgesic medication classes were opioids (41%) and nonsteroidal anti-inflammatory drugs (34%). Conclusion: The primary headache disorder treatment paradigm is complex, with significant variability. Predominant concomitant use of opioids and switching to opioids is of concern, necessitating solutions to minimize opioid use. Switching to non-oral/fast-acting or targeted preventive therapies should be considered.

scholarly journals Comparing Health Care Financial Burden With an Alternative Measure of Unaffordability

2017 ◽  
Vol 54 ◽  
pp. 004695801773296
Author(s):  
Edward S. Kielb ◽  
Corwin N. Rhyan ◽  
James A. Lee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Plan ◽  
Low Income ◽  
Access To Health Care ◽  
Financial Burden ◽  
Access To Health ◽  
Care Costs

Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care. We find that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher incomes or Medicare coverage. To better understand the relationship between out-of-pocket (OOP) spending and access, we used the 2011-2014 Medical Expenditure Panel Survey (MEPS) data and a logistic model to analyze the likelihood of avoiding or delaying needed medical care based on health insurance design and other individual and family characteristics. We find that avoiding or delaying medical care is strongly correlated with coverage under a high-deductible health plan, and with depression, poor perceived health, or poverty. However, it is relatively independent of the percent of income spent on OOP costs, making the percent of income spent on OOP costs by itself a poor measure of health care unaffordability. Individuals who spend a small percentage of their income on health care costs may still be extremely burdened by their health plan when financial concerns prevent access to health care. This work emphasizes the importance of insurance design as a predictor of access and the need to expand the definition of financial barriers to care beyond expenditures, particularly for the low-income, privately insured population.

Abstract 124: The Effect of Renal Impairment on The Venous Thromboembolism Recurrence and Major Bleeding Risk and Total Health Care Costs in Patients With Acute Venous Thromboembolism

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Jennifer Cai ◽  
Jackie Kwong ◽  
Ron Preblick ◽  
Qiaoyi Zhang
Keyword(s):  
Health Care ◽  
Venous Thromboembolism ◽  
Renal Impairment ◽  
Health Care Costs ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Index Date ◽  
Disease Stage ◽  
Care Costs

Background: Renal impairment could be a risk factor for venous thromboembolism (VTE) recurrence and anticoagulation related bleeding in VTE patients. The objective of this study was to assess the effect of renal impairment on the risk of VTE recurrence, major bleeding and total health care costs in patients with acute VTE. Methods: In this retrospective analysis of IMS PharMetrics Plus TM claims database, patients (≥18 years old) who had ≥ 1 inpatient or ≥ 2 outpatient VTE claims during January 2010-December 2013 (the index period) were identified. Patients who had continuous enrollment eligibility for at least 12 months before (baseline) and 12 months after (follow-up) the index date (first VTE claim) and had no VTE diagnosis and anticoagulant treatment during baseline period were included. Patients who required dialysis or had end stage renal disease were excluded. VTE patients with chronic kidney disease (stage I-IV or equivalent) during baseline based on ICD- 9 diagnosis codes were compared with those without renal impairment. Recurrent VTE was identified by inpatient or emergency department claims associated with VTE diagnosis after hospital discharge of the index VTE event or 7 days after index date for patients with index VTE events treated in the outpatient setting during the follow-up period. Major bleeding events were identified by inpatient claims with a bleeding diagnosis that occurred after an anticoagulant prescription fill among patients receiving anticoagulant therapy. Cox proportional hazards models adjusted for age, gender, index VTE type, health insurance type, outpatient anticoagulant therapy use, and baseline comorbidities was used to assess the risk of VTE recurrence and anticoagulation related major bleeding. Generalized linear model with gamma distribution and log link was used to evaluate the total health care costs (inclusive of medical and pharmacy costs) over the 1-year follow-up period adjusting for the same baseline characteristics. Results: Of 20,873 eligible VTE patients (median age 57 years; 50% female), 238 had diagnosed renal impairment. Compared with patients without renal impairment, patients with renal impairment had higher rates for VTE recurrence (24% vs. 18%; adjusted hazard ratio (HR) = 1.32, 95% CI 1.06-1.63, p<0.01), and post anticoagulation major bleeding (4% vs 1%; HR=1.75, 95% CI 1.01-3.03, p=0.046). Patients with renal impairment had higher adjusted mean total health care costs ($41,283 vs. $30,757, p<0.01) than patients without renal impairment. Conclusion: VTE patients with renal impairment had higher risk for VTE recurrence and major bleeding associated with anticoagulant therapy, resulting in increased utilization of health care resources than VTE patients without renal impairment. Sponsorship: This research was funded by Daiichi Sankyo Inc, Parsippany, NJ.

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