An analysis of the cost of clinical surveillance after primary therapy for women with early stage invasive breast cancer.
Routine surveillance for distant metastases in women with early stage breast cancer has limited clinical utility and can result in large medical care costs.
In order to estimate breast cancer surveillance costs, we used the results of a survey administered to a random sample of physician members of the American Society of Clinical Oncology.
The survey measured the frequency in which radiographic and laboratory tests are ordered for postmenopausal women with stage I or II breast cancer after the completion of surgery and radiation or adjuvant chemotherapy if indicated.
There were 209 completed surveys representing a response rate of 48%. The volume of tests ordered was expressed in terms of Medicare's relative value units (RVUs) and 1993 cost equivalents.
The mean total RVUs over 5 years post-diagnosis was 43.8 (interquartile range 30.1-54.2) which represents a cost of $1369 using the 1993 Medicare conversion factor of $31.249.
A cumulative logistic regression model categorized RVUs according to intensity of care (minimal, average, and intensive).
While medical oncologists compared to surgeons and radiation oncologists, and physicians practicing in the Northeast and Midwest, compared to those practicing in the South and West, were more likely to adopt an intensive practice style, these differences were not statistically significant (p=0.1).
None of the other provider characteristics evaluated, including gender, prior experience, and practice type, had a sig...
Mots-clés Pascal : Analyse coût, Surveillance sanitaire, Métastase, Stade précoce, Tumeur maligne, Glande mammaire, Homme, Femelle, Postménopause, Diagnostic, Exploration radiologique, Examen laboratoire, Etude longitudinale, Etats Unis, Amérique du Nord, Amérique, Epidémiologie, Glande mammaire pathologie
Mots-clés Pascal anglais : Cost analysis, Sanitary surveillance, Metastasis, Early stage, Malignant tumor, Mammary gland, Human, Female, Postmenopause, Diagnosis, Radiologic investigation, Laboratory investigations, Follow up study, United States, North America, America, Epidemiology, Mammary gland diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0110996
Code Inist : 002B20E02. Création : 199608.