Patterns in provider types and cost of surveillance testing in early-stage breast cancer patients: A regional study
| العنوان: | Patterns in provider types and cost of surveillance testing in early-stage breast cancer patients: A regional study |
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| المؤلفون: | Catherine R. Fedorenko, Julia Rose Walker, Richard A. McGee, Scott D. Ramsey, Sarah Barger, Laura Panattoni, Stuart Greenlee, Gary H. Lyman, Mikael Anne Greenwood-Hickman, Bruce Smith, Ted Conklin, Sibel Blau, Karma L. Kreizenbeck |
| المصدر: | Journal of Clinical Oncology. 35:6582-6582 |
| بيانات النشر: | American Society of Clinical Oncology (ASCO), 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | 0301 basic medicine, Cancer Research, medicine.medical_specialty, business.industry, medicine.medical_treatment, General surgery, Lumpectomy, Specialty, medicine.disease, Asymptomatic, Surgery, Cancer registry, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Breast cancer, Oncology, 030220 oncology & carcinogenesis, medicine, medicine.symptom, Stage (cooking), business, Mastectomy, Tumor marker |
| الوصف: | 6582 Background: Although ASCO Choosing Wisely guidelines recommend against routine surveillance testing or imaging for asymptomatic individuals with early-stage breast cancer (ESBC) treated with curative intent, they are frequently performed. Physician specialty and costs associated with surveillance testing and imaging were examined in ESBC patients. Methods: Cancer registry patient records in Western Washington from 2007 to 2015 were linked with claims from two regional commercial insurers. Selected patients had been diagnosed with stage I/II breast cancer and treated with mastectomy or lumpectomy + radiation. Surveillance was considered from the first 4 month gap in treatment (surgery, chemo, radiation) through 13 months or restart of treatment. Evaluation and Management (E&M) and procedure codes for tumor marker (CEA, CA 15-3, CA 27.29) and advanced imaging (PET, CT, bone scan) were identified. Specialty codes were used to determine provider type. Physician visits were matched to tests using E&M codes in the +/- 7 days around each test. Cost included total reimbursed amount from insurers during the surveillance period. Results: During surveillance, 2,193 patients averaged 13.3 physician visits [median: 11, IQR: 8-17]. Oncologists (91%) and PCPs (83%) were the most common specialties with an average of 3.7 visits each. Overall, 37% of patients received tumor marker tests (avg = 2.8 tests/patient) and 17% received advanced imaging (avg = 1.5 images/patient). The mean total cost during the surveillance period was $18,403 (SD $26,640). Costs were higher for those patients who received tumor marker testing or advanced imaging. Conclusions: Patients frequently see oncologists and PCPs during early surveillance. Targeting oncologists to improve appropriate tumor marker testing could have the largest impact on aligning practice with Choosing Wisely recommendations and potentially reducing the financial burden on patients. [Table: see text] |
| تدمد: | 1527-7755 0732-183X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::82c02176e97ae4e73cfed2a538a6b12f https://doi.org/10.1200/jco.2017.35.15_suppl.6582 |
| رقم الأكسشن: | edsair.doi...........82c02176e97ae4e73cfed2a538a6b12f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15277755 0732183X |
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