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The Association of Hematological Malignancy and End-of-Life Expenditure in Cancer Decedents: A Population-Based Study in an Asian Country.

Hung YT, Huang CY, Chang CM, Lee CC - Medicine (Baltimore) (2015)

Bottom Line: Within the overall National Health Insurance (NHI) budget in Taiwan, there has been a remarkable increase in expenditure for cancer patients.There were 42,754 cancer patients enrolled in order to study the determinants of medical expenditure for EOL care from 2009 to 2011.The mean medical expenditure for EOL care for cancer patients in the last 6 months of life was $12,965 ± 10,959 (mean ± standard deviation ) (all costs are given in US dollars).Treatment strategies for acute leukemia should be studied further in order to save the health care budget.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Pediatrics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (Y-TH); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (C-YH); Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (C-CL); Center for Clinical Epidemiology and Biostatistics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (C-CL); School of Medicine, Tzu Chi University, Hualian, Taiwan (Y-TH, C-MC, C-CL); Community Medicine Research Center and the Institute of Public Health, National Yang-Ming University, Taipei, Taiwan (C-CL); and Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (C-MC).

ABSTRACT
Within the overall National Health Insurance (NHI) budget in Taiwan, there has been a remarkable increase in expenditure for cancer patients. This study was designed to explore whether hematological malignancy is associated with higher end-of-life (EOL) medical expenditure in their last 6 months of life.We used data from the Taiwan NHI Research Database to do a retrospective cohort and population-based study. There were 42,754 cancer patients enrolled in order to study the determinants of medical expenditure for EOL care from 2009 to 2011.The mean medical expenditure for EOL care for cancer patients in the last 6 months of life was $12,965 ± 10,959 (mean ± standard deviation ) (all costs are given in US dollars). Patients with acute leukemia and lymphoma had an additional cost of $16,934 and $7840 than those with nonhematological malignancy (P < 0.001). Medical expenditures for cancer patients with a hematological malignancy and postdiagnosis survival of >6 months, between 6 and 12 months, and >12 months all showed that acute leukemia and lymphoma accounted for more medical expenditure than did others (P < 0.001). The primary physician's specialty between acute leukemia, lymphoma, and nonhematological malignancy patients had statistically difference.The medical expenditure of cancer patients in acute leukemia and lymphoma was more than nonhematological malignancy. Treatment strategies for acute leukemia should be studied further in order to save the health care budget.

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Related in: MedlinePlus

(A) Medical expenditure in the last 6 months of life in cancer patients with postdiagnosis survival between 6 and 12 months. (B) Medical expenditure in the last 6 months of life in cancer patients with postdiagnosis survival >12 months.
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Figure 2: (A) Medical expenditure in the last 6 months of life in cancer patients with postdiagnosis survival between 6 and 12 months. (B) Medical expenditure in the last 6 months of life in cancer patients with postdiagnosis survival >12 months.

Mentions: The medical cost in the last 6 months of life in cancer patients with acute leukemia and lymphoma had an additional cost of $16,934 and $7840 than those with nonhematological malignancy (P < 0.001) (Table 2). Figure 1 depicts the medical expenditure in the last 6 months of life in cancer patients, and Figure 2A for those with postdiagnosis survival between 6 and 12 months and Figure 2B for those with postdiagnosis survival of >12 months. Medical expenditures of last 6 months of life for cancer patients with a hematological malignancy and postdiagnosis survival of >6 months, between 6 and 12 months, and >12 months all showed that acute leukemia and lymphoma accounted for more medical expenditure than did others (P < 0.001) (Tables 2 and 3) (Figures 1 and 2A and B).


The Association of Hematological Malignancy and End-of-Life Expenditure in Cancer Decedents: A Population-Based Study in an Asian Country.

Hung YT, Huang CY, Chang CM, Lee CC - Medicine (Baltimore) (2015)

(A) Medical expenditure in the last 6 months of life in cancer patients with postdiagnosis survival between 6 and 12 months. (B) Medical expenditure in the last 6 months of life in cancer patients with postdiagnosis survival >12 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4504639&req=5

Figure 2: (A) Medical expenditure in the last 6 months of life in cancer patients with postdiagnosis survival between 6 and 12 months. (B) Medical expenditure in the last 6 months of life in cancer patients with postdiagnosis survival >12 months.
Mentions: The medical cost in the last 6 months of life in cancer patients with acute leukemia and lymphoma had an additional cost of $16,934 and $7840 than those with nonhematological malignancy (P < 0.001) (Table 2). Figure 1 depicts the medical expenditure in the last 6 months of life in cancer patients, and Figure 2A for those with postdiagnosis survival between 6 and 12 months and Figure 2B for those with postdiagnosis survival of >12 months. Medical expenditures of last 6 months of life for cancer patients with a hematological malignancy and postdiagnosis survival of >6 months, between 6 and 12 months, and >12 months all showed that acute leukemia and lymphoma accounted for more medical expenditure than did others (P < 0.001) (Tables 2 and 3) (Figures 1 and 2A and B).

Bottom Line: Within the overall National Health Insurance (NHI) budget in Taiwan, there has been a remarkable increase in expenditure for cancer patients.There were 42,754 cancer patients enrolled in order to study the determinants of medical expenditure for EOL care from 2009 to 2011.The mean medical expenditure for EOL care for cancer patients in the last 6 months of life was $12,965 ± 10,959 (mean ± standard deviation ) (all costs are given in US dollars).Treatment strategies for acute leukemia should be studied further in order to save the health care budget.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Pediatrics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (Y-TH); Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan (C-YH); Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (C-CL); Center for Clinical Epidemiology and Biostatistics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (C-CL); School of Medicine, Tzu Chi University, Hualian, Taiwan (Y-TH, C-MC, C-CL); Community Medicine Research Center and the Institute of Public Health, National Yang-Ming University, Taipei, Taiwan (C-CL); and Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan (C-MC).

ABSTRACT
Within the overall National Health Insurance (NHI) budget in Taiwan, there has been a remarkable increase in expenditure for cancer patients. This study was designed to explore whether hematological malignancy is associated with higher end-of-life (EOL) medical expenditure in their last 6 months of life.We used data from the Taiwan NHI Research Database to do a retrospective cohort and population-based study. There were 42,754 cancer patients enrolled in order to study the determinants of medical expenditure for EOL care from 2009 to 2011.The mean medical expenditure for EOL care for cancer patients in the last 6 months of life was $12,965 ± 10,959 (mean ± standard deviation ) (all costs are given in US dollars). Patients with acute leukemia and lymphoma had an additional cost of $16,934 and $7840 than those with nonhematological malignancy (P < 0.001). Medical expenditures for cancer patients with a hematological malignancy and postdiagnosis survival of >6 months, between 6 and 12 months, and >12 months all showed that acute leukemia and lymphoma accounted for more medical expenditure than did others (P < 0.001). The primary physician's specialty between acute leukemia, lymphoma, and nonhematological malignancy patients had statistically difference.The medical expenditure of cancer patients in acute leukemia and lymphoma was more than nonhematological malignancy. Treatment strategies for acute leukemia should be studied further in order to save the health care budget.

Show MeSH
Related in: MedlinePlus