Medicare spending for advanced cancer not linked to survival differences

Substantial regional variation in Medicare spending for patients with advanced cancer is not linked to differences in survival, according to a study published March 12 in the Journal of the National Cancer Institute.

Cancer care accounts for approximately 10% of Medicare spending, and costs are highest for cancer patients with late-stage disease. Prior research studies have shown that there are large regional differences in spending within the , however it is unknown if higher average regional spending for advanced cancer is linked to improved survival for individual patients with cancer.

In order to determine the link between spending and advanced cancer survival, Gabriel Brooks, M.D., of the Dana-Farber Cancer Institute in Boston, and colleagues, used the Surveillance, Epidemiology and End Results (SEER)-Medicare linked data to study patients with advanced lung, colorectal, pancreas, breast and prostate cancer between 2002 and 2007. The patients lived in one of 80 hospital referral regions covering over one quarter of the U.S population. Researchers measured the average spending for patients with advanced cancer by region, and then compared survival between regions grouped by increasing advanced cancer spending.

The researchers found that advanced cancer spending varied by up to 41% between high- and low-spending regions. Despite this substantial spending variation, there was no direct link between regional spending and advanced . Higher spending was strongly linked with more frequent and longer hospital visits. "The identification of inpatient hospitalization as a key driver of in advanced cancer spending is an important finding at a time when much attention on the cost of has been focused on the cost of chemotherapy," the authors write. "Our findings suggest that health-care providers should be incentivized to develop strategies aimed at reducing potentially avoidable hospitalizations and increasing timely access to palliative care for patients with advanced cancer—goals that are consistent with patient centered care.

Explore further

Higher Medicare spending yields mixed bag for patients

Citation: Medicare spending for advanced cancer not linked to survival differences (2013, March 12) retrieved 2 August 2021 from
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Feedback to editors

User comments