Clinical surveillance for early stage breast cancer : an analysis of claims data.
This study estimates the costs of clinical follow-up for women with early stage breast cancer and evaluates the effects of patient and provider characteristics on follow-up intensity.
Claims data were cumulated from 1/1/89 through 4/30/93 for a comprehensive set of follow-up tests (office visits, radiologic, and laboratory) ordered for 222 women diagnosed at a university hospital between 1/1/89 and 12/31/91.
Aggregated measures of the volume and costs of follow-up over 6 month intervals were expressed in terms of Medicare's 1993 relative value units (RVUs) and their 1993 cost equivalents.
Excluding the first 6 months, women received on average, 11.7 RVUs of follow-up in the first year (equivalent to a cost of $362), and 9.5 RVUs in the second year ($297).
In the first year, chest x-rays, clinical chemistry tests, automated hemograms, and bone scans, accounted for 36% of the cost of follow-up. while computerized tomographic scans and magnetic resonance imaging studies accounted for 30%. Multiple regression analysis of the first year data showed that women who received radiation and/or were followed by oncology, were more likely to receive intensive follow-up.
Age. race, socioeconomic status, insurance, stage, and treatment did not impact follow-up.
Costs of follow-up for breast cancer are substantial, though much lower than suggested by others.
Additionally, wide variations in practice are largely unexplained by patient and/or provider characteristics. (...)
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Stade précoce, Homme, Femelle, Surveillance, Economie santé, Analyse coût, Glande mammaire pathologie
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Early stage, Human, Female, Surveillance, Health economy, Cost analysis, Mammary gland diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0447039
Code Inist : 002B20E02. Création : 10/04/1997.