Wednesday, July 28, 2010 (Last Updated: 07/29/2010)
WEDNESDAY, July 28 (HealthDay News) -- Continuing care for Medicare beneficiaries with prostate cancer is associated with considerable variation, suggesting unnecessarily high expenditures for the health care system, according to research published in the August issue of The Journal of Urology.
Ted A. Skolarus, M.D., of the University of Michigan in Ann Arbor, and colleagues analyzed Surveillance, Epidemiology, and End Results-Medicare data on 105,961 patients diagnosed with prostate cancer between 1992 and 2005. The researchers sorted Medicare payments for prostate cancer care by initial phase, continuing care, or end of life, and divided patients into five equal quintiles based on annual per capita expenditures for continuing care.
The researchers found that mean continuing care expenditures per capita ranged from $36 per year in the lowest quintile to $4,724 per year in the highest quintile. Office visits and androgen deprivation (27.3 and 62.7 percent, respectively) accounted for most physician-related payments for survivorship care. In patients with similar spending, the variation in each cancer risk stratum -- such as low-risk or metastatic disease -- was greater than the variation between risk strata.
"In Medicare beneficiaries, the continuing care phase of prostate cancer is associated with substantial variation, potentially resulting in unnecessary excess cost to the health care system. Variation was evident across the spectrum of disease severity and implies the need for better evidence to inform clinical practice. Decreasing unnecessary androgen deprivation provides the greatest opportunity to decrease cost and improve quality of care for prostate cancer survivors," the authors conclude.
The study was funded in part by Astellas Pharma.
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