scholarly journals Economic Burden of Chronic Conditions Among Survivors of Cancer in the United States

2017 ◽  
Vol 35 (18) ◽  
pp. 2053-2061 ◽  
Author(s):  
Gery P. Guy ◽  
K. Robin Yabroff ◽  
Donatus U. Ekwueme ◽  
Sun Hee Rim ◽  
Rui Li ◽  
...  
Keyword(s):  
Heart Disease ◽  
Economic Burden ◽  
Chronic Conditions ◽  
The United States ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Multiple Chronic Conditions ◽  
Lost Productivity ◽  
History Of ◽  
History Of Cancer

Purpose The prevalence of cancer survivorship and chronic health conditions is increasing. Limited information exists on the economic burden of chronic conditions among survivors of cancer. This study examines the prevalence and economic effect of chronic conditions among survivors of cancer. Methods Using the 2008 to 2013 Medical Expenditure Panel Survey, we present nationally representative estimates of the prevalence of chronic conditions (heart disease, high blood pressure, stroke, emphysema, high cholesterol, diabetes, arthritis, and asthma) and multiple chronic conditions (MCCs) and the incremental annual health care use, medical expenditures, and lost productivity for survivors of cancer attributed to individual chronic conditions and MCCs. Incremental use, expenditures, and lost productivity were evaluated with multivariable regression. Results Survivors of cancer were more likely to have chronic conditions and MCCs compared with adults without a history of cancer. The presence of chronic conditions among survivors of cancer was associated with substantially higher annual medical expenditures, especially for heart disease ($4,595; 95% CI, $3,262 to $5,927) and stroke ($3,843; 95% CI, $1,983 to $5,704). The presence of four or more chronic conditions was associated with increased annual expenditures of $10,280 (95% CI, $7,435 to $13,125) per survivor of cancer. Annual lost productivity was higher among survivors of cancer with other chronic conditions, especially stroke ($4,325; 95% CI, $2,687 to $5,964), and arthritis ($3,534; 95% CI, $2,475 to $4,593). Having four or more chronic conditions was associated with increased annual lost productivity of $9,099 (95% CI, $7,224 to $10,973) per survivor of cancer. The economic impact of chronic conditions was similar among survivors of cancer and individuals without a history of cancer. Conclusion These results highlight the importance of ensuring access to lifelong personalized screening, surveillance, and chronic disease management to help manage chronic conditions, reduce disruptions in employment, and reduce medical expenditures among survivors of cancer.

scholarly journals Economic Burden of Cancer Survivorship Among Adults in the United States

2013 ◽  
Vol 31 (30) ◽  
pp. 3749-3757 ◽  
Author(s):  
Gery P. Guy ◽  
Donatus U. Ekwueme ◽  
K. Robin Yabroff ◽  
Emily C. Dowling ◽  
Chunyu Li ◽  
...  
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Economic Burden ◽  
The United States ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Lost Productivity ◽  
History Of ◽  
History Of Cancer

Purpose To present nationally representative estimates of the impact of cancer survivorship on medical expenditures and lost productivity among adults in the United States. Methods Using the 2008 to 2010 Medical Expenditure Panel Survey, we identified 4,960 cancer survivors and 64,431 individuals without a history of cancer age ≥ 18 years. Direct medical costs were measured using annual health care expenditures and examined by source of payment and service type. Indirect morbidity costs were estimated from lost productivity as a result of employment disability, missed work days, and lost household productivity. We evaluated the economic burden of cancer survivorship by estimating excess costs among cancer survivors, stratified by time since diagnosis (recently diagnosed [≤ 1 year] and previously diagnosed [> 1 year]), compared with individuals without a history of cancer using multivariable regression models stratified by age (18 to 64 and ≥ 65 years), controlling for age, sex, race/ethnicity, education, and comorbidities. Results In 2008 to 2010, the annual excess economic burden of cancer survivorship among recently diagnosed cancer survivors was $16,213 per survivor age 18 to 64 years and $16,441 per survivor age ≥ 65 years. Among previously diagnosed cancer survivors, the annual excess burden was $4,427 per survivor age 18 to 64 years and $4,519 per survivor age ≥ 65 years. Excess medical expenditures composed the largest share of the economic burden among cancer survivors, particularly among those recently diagnosed. Conclusion The economic impact of cancer survivorship is considerable and is also high years after a cancer diagnosis. Efforts to reduce the economic burden caused by cancer will be increasingly important given the growing population of cancer survivors.

Is cancer history associated with asset ownership, debt, and net worth in the United States?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18085-e18085
Author(s):  
Maryam Doroudi ◽  
Diarmuid Coughlan ◽  
Matthew P. Banegas ◽  
K Robin Yabroff
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
The United States ◽  
Medical Expenditure ◽  
Age Group ◽  
Asset Ownership ◽  
Cancer History ◽  
Net Worth ◽  
History Of ◽  
History Of Cancer

e18085 Background: Financial hardships experienced by cancer survivors in the United States have become significant social and public health issues. Few studies have assessed the underlying financial holdings, including ownership and values of assets and debts, of individuals following a cancer diagnosis. This study assessed the association between a cancer history and asset ownership, debt, and net worth. Methods: We identified 1,603 cancer survivors and 34,915 individuals without a history of cancer aged 18-64 from the nationally representative Medical Expenditure Panel Survey (MEPS) Household Component and Asset sections (years 2008-2011). Descriptive statistics were used to assess demographic characteristics, cancer history, asset ownership, debt, and net worth by cancer history. Regression analysis was conducted to assess the association between cancer history and net worth, stratified by age group (18-34, 35-44, 45-54, and 55-64 years) to reflect stages of the life-course. Results: Asset ownership was least common for cancer survivors and individuals without a cancer history in the 18-34 age group and most common in the 55-64 age group. Cancers survivors aged 45-54 had a lower proportion of home ownership than individuals without a cancer history (59% vs 67%; p = 0.001). Nearly 20% of all respondents reported at least some debt. The proportion of cancer survivors with debt was higher than individuals without a history of cancer, especially in the 18-34 age group (41% vs 27%; p < 0.001), although it did not vary by age group. When asset and debt values were combined to assess net worth, cancer survivors aged 45-54 were significantly more likely to have a negative net worth and significantly less likely to have a positive net worth than those individuals without a history of cancer in fully adjusted models. Findings on net worth were similar in the 18-34 age group, although only statistically significant in unadjusted and partially adjusted models. Conclusions: We found that cancer history is associated with asset ownership, debt, and net worth, especially in those aged 45-54 years. Longitudinal studies to assess patterns of financial holdings throughout the cancer experience are warranted.

Cancer survivors with multiple chronic conditions: A rising challenge—Trend analysis from National Health Interview Survey.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24089-e24089
Author(s):  
Changchuan Jiang ◽  
Haowei Wang ◽  
Qian Wang ◽  
Binbin Zheng ◽  
Charles L. Shapiro
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Cancer Survivors ◽  
Chronic Conditions ◽  
National Health Interview Survey ◽  
Heart Diseases ◽  
Multiple Chronic Conditions ◽  
History Of ◽  
Interview Survey ◽  
History Of Cancer

e24089 Background: Cancer survivors are disproportionally influenced by chronic/comorbid diseases, which were linked to more psychological distress, increased healthcare service use, higher medical costs, adverse clinical outcomes, and financial hardship in cancer survivors. However, the trend in chronic diseases remains unknown among cancer survivors. Methods: We conducted a population-based study using serial samples of the National Health Interview Survey (NHIS) from 2002 through 2018. The outcomes include hypertension, diabetes, stroke, coronary artery disease (angina pectoris, coronary heart disease, heart attack), other heart diseases, COPD (emphysema, chronic bronchitis in the past 12 month), hepatitis, arthritis, morbid obesity (BMI > 40 or BMI > 35 with obesity-related diseases), asthma attack within 12 months, weak/failing kidney, any liver disease. We included adults who 1) have a history of cancer for except non-melanoma skin cancer; 2) report outcomes of diseases. Multiple chronic conditions(MCC) were defined as three or more non-cancer chronic conditions. Multivariable logistics regression was used to estimate the annual percent change(APC) in prevalence from 2002 to 2018, using SAS 9.4 and accounting for the design of NHIS. Results: 30728 adult cancer survivors and 485233 adults without a history of cancer were included in the final analysis. We found increasing prevalence in hypertension, diabetes, kidney disease, liver diseases and morbid obesity from 2002 to 2018, and decreasing prevalence in heart diseases, COPD, and hepatitis. The prevalence of MCC increased significantly in cancer survivors from 23.6% in 2002 to 29.6% in 2018 (APC 0.9%, p trend < 0.01). This was especially evident in younger patients aged 18 to 44 (APC 4.4%, p trend < 0.01) and African-American patients (APC 2.2%, p trend = 0.01). Conclusions: Our findings suggest that comorbid illnesses, especially MCC, have become an emerging public health burden for cancer survivors, which requires attention and more effective risk factors interventions. Future studies are needed to identify a better strategy to modify risk factors and prevent long term comorbidities for cancer survivors. It is also important to call for public health planning given severe chronic diseases burden for this rapid-growing but vulnerable community.

The economic burden of vertigo and dizziness in the United States

2020 ◽  
pp. 1-10
Author(s):  
Jeremy S. Ruthberg ◽  
Chandruganesh Rasendran ◽  
Armine Kocharyan ◽  
Sarah E. Mowry ◽  
Todd D. Otteson
Keyword(s):  
United States ◽  
Health Care ◽  
Economic Burden ◽  
Clinical Characteristics ◽  
Care Service ◽  
Adult Population ◽  
Health Care Service ◽  
The United States ◽  
Medical Expenditures ◽  
Limited Information

BACKGROUND: Vertigo and dizziness are extremely common conditions in the adult population and therefore place a significant social and economic burden on both patients and the healthcare system. However, limited information is available for the economic burden of vertigo and dizziness across various health care settings. OBJECTIVE: Estimate the economic burden of vertigo and dizziness, controlling for demographic, socioeconomic, and clinical comorbidities. METHODS: A retrospective analysis of data from the Medical Expenditures Panel Survey (2007–2015) was performed to analyze individuals with vertigo or dizziness from a nationally representative sample of the United States. Participants were included via self-reported data and International Classification of Diseases, 9th Revision Clinical Modification codes. A cross-validated 2-component generalized linear model was utilized to assess vertigo and dizziness expenditures across demographic, socioeconomic and clinical characteristics while controlling for covariates. Costs and utilization across various health care service sectors, including inpatient, outpatient, emergency department, home health, and prescription medications were evaluated. RESULTS: Of 221,273 patients over 18 years, 5,275 (66% female, 34% male) reported either vertigo or dizziness during 2007–2015. More patients with vertigo or dizziness were female, older, non-Hispanic Caucasian, publicly insured, and had significant clinical comorbidities compared to patients without either condition. Furthermore, each of these demographic, socioeconomic, and clinical characteristics lead to significantly elevated costs due to having these conditions for patients. Significantly higher medical expenditures and utilization across various healthcare sectors were associated with vertigo or dizziness (p <  0.001). The mean incremental annual healthcare expenditure directly associated with vertigo or dizziness was $2,658.73 (95% CI: 1868.79, 3385.66) after controlling for socioeconomic and demographic characteristics. Total annual medical expenditures for patients with dizziness or vertigo was $48.1 billion. CONCLUSION: Vertigo and dizziness lead to substantial expenses for patients across various healthcare settings. Determining how to limit costs and improve the delivery of care for these patients is of the utmost importance given the severe morbidity, disruption to daily living, and major socioeconomic burden associated with these conditions.

scholarly journals Onset of Multiple Chronic Conditions and Depressive Symptoms: A Life Events Perspective

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Maureen Wilson-Genderson ◽  
Allison R Heid ◽  
Rachel Pruchno
Keyword(s):  
Heart Disease ◽  
Depressive Symptoms ◽  
Pulmonary Disease ◽  
Chronic Conditions ◽  
Clinical Care ◽  
Psychological Impact ◽  
Multiple Chronic Conditions ◽  
Care Providers ◽  
The Subject ◽  
Independent Effects

Abstract Background While the association between depressive symptoms and chronic illness has been the subject of many studies, little is known about whether depressive symptoms differ as a function of the illnesses people have as they transition to living with multiple chronic conditions. Methods Self-reports of five diagnosed chronic conditions (arthritis, diabetes, heart disease, hypertension, and pulmonary disease) and depressive symptoms were provided by 3,396 people participating in three waves of the ORANJ BOWLSM research panel. Longitudinal multilevel modeling was used to examine the effects that transitioning to having a diagnosis of multiple chronic conditions has on depressive symptoms. Results Between 2006 and 2014, controlling for age, gender, income, race, and a lifetime diagnosis of depression, people who transitioned to having a diagnosis of multiple chronic conditions had significantly higher levels of depressive symptoms than people who did not make this transition. The diagnosis of arthritis, diabetes, heart disease, and pulmonary disease, but not hypertension had independent effects, increasing depressive symptoms. Conclusions Having a diagnosis of multiple chronic conditions leads to increases in depressive symptoms, but not all illnesses have the same effect. Findings highlight the need for clinicians to be aware of mental health risks in patients diagnosed with multiple chronic conditions, particularly those with a diagnosis of arthritis, diabetes, heart disease, and pulmonary disease. Clinical care providers should take account of these findings, encouraging psychosocial supports for older adults who develop multiple chronic conditions to minimize the negative psychological impact of illness diagnosis.

scholarly journals Identifying Predictive Characteristics of Opioid Medication Use among a Nationally Representative Sample of United States Older Adults with Pain and Comorbid Hypertension or Hypercholesterolemia

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 341
Author(s):  
David R. Axon ◽  
Shannon Vaffis ◽  
Srujitha Marupuru
Keyword(s):  
United States ◽  
Older Adults ◽  
Representative Sample ◽  
Chronic Conditions ◽  
Functional Limitation ◽  
The United States ◽  
Medical Expenditure ◽  
Opioid Use ◽  
Nationally Representative ◽  
Opioid Users

The prevalence of older adults with pain and comorbid cardiovascular conditions is increasing in the United States (U.S.). This retrospective, cross-sectional database study used 2017 Medical Expenditure Panel Survey data and hierarchical logistic regression models to identify predictive characteristics of opioid use among a nationally representative sample of older U.S. adults (aged ≥50 years) with pain in the past four weeks and comorbid hypertension (pain–hypertension group) or hypercholesterolemia (pain–hypercholesterolemia group). The pain–hypertension group included 2733 subjects (n = 803 opioid users) and the pain–hypercholesterolemia group included 2796 subjects (n = 795 opioid users). In both groups, predictors of opioid use included: White race versus others, Hispanic versus non-Hispanic ethnicity, 1 versus ≥5 chronic conditions, little/moderate versus quite a bit/extreme pain, good versus fair/poor perceived mental health, functional limitation versus no functional limitation, smoker versus non-smoker, and Northeast versus West census region. In addition, Midwest versus West census region was a predictor in the pain–hypertension group, and 4 versus ≥5 chronic conditions was a predictor in the pain–hypercholesterolemia group. In conclusion, several characteristics of older U.S. adults with pain and comorbid hypertension or hypercholesterolemia were predictive of opioid use. These characteristics could be addressed to optimize individuals’ pain management and help address the opioid overdose epidemic.

scholarly journals IMPACT OF MULTIPLE CHRONIC CONDITIONS ON CHANGE IN PHYSICAL FUNCTION FROM MID- TO EARLY LATE LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S540-S540
Author(s):  
Brittney S Lange Maia ◽  
Kelly Karavolos ◽  
Elsa Strotmeyer ◽  
Carrie Karvonen-Gutierrez ◽  
Elizabeth Avery ◽  
...  
Keyword(s):  
Heart Disease ◽  
Physical Function ◽  
Chronic Conditions ◽  
Additional Condition ◽  
Late Life ◽  
Multiple Chronic Conditions ◽  
Poisson Models ◽  
Sf 36 ◽  
Health Factors ◽  
Early Late

Abstract Chronic conditions emerging in midlife may be modifiable to prevent progression ultimately preserve physical function (PF) in late life. We quantified change in perceived PF in relation to several common chronic conditions known to impact PF in late life (osteoarthritis, diabetes, stroke, hypertension, heart disease, cancer, osteoporosis, and depression). Physical function (PF) was assessed using the Physical Functioning Scale of the SF-36 among 2,283 women in SWAN from an average age of 50.0±2.7 to 64.0±3.7 years. In covariate-adjusted Poisson models, each additional condition was associated with 3% worse PF (p&lt;0.001), and an additional 0.4% annual worsening (p&lt;0.001). Thus, holding demographic, lifestyle, socioeconomic, and other health factors constant, a woman a decade later entering old age with no chronic conditions would have 8.1%, 15.5%, and 17.0% better PF vs. having one, two, or three conditions, respectively. Preventing or delaying chronic disease progression in midlife may improve PF trajectories into late life.

scholarly journals Differences in chronic conditions and lifestyle behaviour between people with a history of cancer and matched controls

2014 ◽  
Vol 201 (2) ◽  
pp. 96-100 ◽  
Author(s):  
Narelle M Berry ◽  
Michelle D Miller ◽  
Richard J Woodman ◽  
John Coveney ◽  
James Dollman ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Lifestyle Behaviour ◽  
History Of ◽  
History Of Cancer

Individual and Organizational Factors Associated With Hospital Readmission Rates: Evidence From a U.S. National Sample

2019 ◽  
Vol 39 (10) ◽  
pp. 1153-1158 ◽  
Author(s):  
Kyaien O. Conner ◽  
Hongdao Meng ◽  
Victoria Marino ◽  
Timothy L. Boaz
Keyword(s):  
Hospital Readmission ◽  
Chronic Conditions ◽  
Transitional Care ◽  
Hospital Readmissions ◽  
Severity Of Illness ◽  
Organizational Factors ◽  
The United States ◽  
Multiple Chronic Conditions ◽  
Important Indicator ◽  
Increased Risk

Objective: Hospital readmission rate is an important indicator for assessing quality of care in the acute and postacute settings. Identifying factors that increase risk for hospital readmissions can aid in the recognition of potential targets for quality improvement efforts. The main objective of this brief report was to examine the factors that predict increased risk of 30-day readmissions. Method: We analyzed data from the 2013 National Readmission Database (NRD). Results: The main factors that predicted increased risk of 30-day readmission were number of chronic conditions, severity of illness, mortality risk, and hospital ownership. Unexpectedly, discharge from a for-profit hospital was associated with greater risk for hospital readmission in the United States. Discussion and Conclusion: These findings suggest that patients with severe physical illness and multiple chronic conditions should be the primary targets for hospital transitional care interventions to help reduce the rate of unnecessary hospital readmissions.

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