Unraveling the high cost of end-of-life care: An oncology care model experience
| العنوان: | Unraveling the high cost of end-of-life care: An oncology care model experience |
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| المؤلفون: | Marcus A. Neubauer, Kathryn Eagye, J. Russell Hoverman, Jad Hayes, Cynthia Taniguchi, B. Brooke Mann |
| المصدر: | Journal of Clinical Oncology. 37:11534-11534 |
| بيانات النشر: | American Society of Clinical Oncology (ASCO), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Cancer Research, medicine.medical_specialty, Oncology, business.industry, Family medicine, medicine, Cancer, medicine.disease, business, End-of-life care |
| الوصف: | 11534 Background: Simply put, cancer care in the last 30 days of life (30DAY) is often aggressive and expensive without best meeting the wishes and needs of patients and caregivers. In this study, we evaluated total and 30DAY cost data for patients who died while enrolled from July 1, 2016 to June 30, 2017 in the Oncology Care Model (OCM), a Medicare (CMS) program initiated by the Center for Medicare and Medicaid Innovation. Methods: CMS provided claims data on 16 OCM-participating US Oncology Network practices. We measured 30DAY OCM episode expenditures (“EXP30”) for n = 5017 deceased patients, as well as patient demographics, clinical outcomes (hospital, ICU, and ER visits) and 30DAY treatments . The population was divided into two cohorts: those with ≥ 3 days of hospice care (“HC”) and those without (“NOHC”). EXP30 was compared between HC and NOHC at the univariate level using Wilcoxon Rank-sums; categorical variables were compared using Chi-squared tests. Multivariate regression was used to determine the effect of HC on EXP30 adjusted for demographic and disease factors. Results: HC had mean EXP30 reduction of $7,192 vs. NOHC [95%CI -$7,628, -$6,730] adjusted for demographics and disease. HC had lower rates of death in hospital (0.03% vs. 43.3%, p < .0001). Mean expense by days before death: NOHC values 0-30 days = $20,701; 31-60 days = $12,962; 61-90 days = $9,952 and HC values 0-30 days = $10,877; 31-60 days = $10,376; 61-90 days = $9,064. Conclusions: All categories of care except HC are associated with significantly higher cost in the last 30 days of life. The dramatic and steep trajectory in the last 30 days suggests high expense but also loss of choices as to how best to live the end of one’s life. The results will be updated as new data become available. [Table: see text] |
| تدمد: | 1527-7755 0732-183X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::b7566fdb07dcdeb45b3d01559d0030a4 https://doi.org/10.1200/jco.2019.37.15_suppl.11534 |
| رقم الأكسشن: | edsair.doi...........b7566fdb07dcdeb45b3d01559d0030a4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15277755 0732183X |
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