Lymphedema Prevalence and Treatment Benefits in Cancer: Impact of a Therapeutic Intervention on Health Outcomes and Costs
Identifieur interne : 002887 ( Main/Exploration ); précédent : 002886; suivant : 002888Lymphedema Prevalence and Treatment Benefits in Cancer: Impact of a Therapeutic Intervention on Health Outcomes and Costs
Auteurs : Kimberly M. Brayton [États-Unis] ; Alan T. Hirsch [États-Unis] ; Patricia J. O Rien [États-Unis] ; Andrea Cheville [États-Unis] ; Pinar Karaca-Mandic [États-Unis] ; Stanley G. Rockson [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Assurance maladie, Coûts des soins de santé, Dispositifs à compression pneumatique intermittente, Femelle, Humains, Jeune adulte, Lymphoedème (), Lymphoedème (économie), Lymphoedème (épidémiologie), Mâle, Prévalence, Résultat thérapeutique, Sujet âgé, Tumeurs (anatomopathologie), Tumeurs (économie), Tumeurs (épidémiologie).
- MESH :
- anatomopathologie : Tumeurs.
- économie : Lymphoedème, Tumeurs.
- épidémiologie : Lymphoedème, Tumeurs.
- Adulte, Adulte d'âge moyen, Assurance maladie, Coûts des soins de santé, Dispositifs à compression pneumatique intermittente, Femelle, Humains, Jeune adulte, Lymphoedème, Mâle, Prévalence, Résultat thérapeutique, Sujet âgé.
English descriptors
- KwdEn :
- Adult, Aged, Female, Health Care Costs, Humans, Insurance, Health, Intermittent Pneumatic Compression Devices, Lymphedema (economics), Lymphedema (epidemiology), Lymphedema (therapy), Male, Middle Aged, Neoplasms (economics), Neoplasms (epidemiology), Neoplasms (pathology), Prevalence, Treatment Outcome, Young Adult.
- MESH :
- economics : Lymphedema, Neoplasms.
- epidemiology : Lymphedema, Neoplasms.
- pathology : Neoplasms.
- therapy : Lymphedema.
- Adult, Aged, Female, Health Care Costs, Humans, Insurance, Health, Intermittent Pneumatic Compression Devices, Male, Middle Aged, Prevalence, Treatment Outcome, Young Adult.
Abstract
Lymphedema is a common complication of cancer therapeutics; its prevalence, treatment outcomes, and costs have been poorly defined. The objective of this study was to examine lymphedema prevalence among cancer survivors and to characterize changes in clinical outcomes and costs associated with a defined therapeutic intervention (use of a pneumatic compression devices [PCD]) in a representative, privately insured population.
Retrospective analysis of de-identified health claims data from a large national insurer for calendar years 2007 through 2013. Patients were required to have 12 months of continuous insurance coverage prior to PCD receipt (baseline), as well as a 12-month follow-up period. Analyses were performed for individuals with cancer-related lymphedema (n = 1,065). Lymphedema prevalence was calculated: number of patients with a lymphedema claim in a calendar year divided by total number of enrollees. The impact of PCD use was evaluated by comparing rates of a pre-specified set of health outcomes and costs for the 12 months before and after, respectively, PCD receipt. Lymphedema prevalence among cancer survivors increased from 0.95% in 2007 to 1.24% in 2013. PCD use was associated with decreases in rates of hospitalizations (45% to 32%, p<0.0001), outpatient hospital visits (95% to 90%, p<0.0001), cellulitis diagnoses (28% to 22%, p = 0.003), and physical therapy use (50% to 41%, p<0.0001). The average baseline health care costs were high ($53,422) but decreased in the year after PCD acquisition (−$11,833, p<0.0001).
Lymphedema is a prevalent medical condition that is often a defining attribute of cancer survivorship. The problem is associated with high health care costs; Treatment (in this instance, use of PCD) is associated with significant decreases in adverse clinical outcomes and costs.
Url:
DOI: 10.1371/journal.pone.0114597
PubMed: 25470383
PubMed Central: 4255037
Affiliations:
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Brayton</name><affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Stanford Center for Lymphatic and Venous Disorders, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Stanford Center for Lymphatic and Venous Disorders, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Hirsch, Alan T" sort="Hirsch, Alan T" uniqKey="Hirsch A" first="Alan T." last="Hirsch">Alan T. Hirsch</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN</wicri:regionArea><wicri:noRegion>MN</wicri:noRegion></affiliation></author><author><name sortKey="O Rien, Patricia J" sort="O Rien, Patricia J" uniqKey="O Rien P" first="Patricia J." last="O Rien">Patricia J. O Rien</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Hematology/Oncology Division, University of Vermont, Burlington, VT, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Hematology/Oncology Division, University of Vermont, Burlington, VT</wicri:regionArea><wicri:noRegion>VT</wicri:noRegion></affiliation></author><author><name sortKey="Cheville, Andrea" sort="Cheville, Andrea" uniqKey="Cheville A" first="Andrea" last="Cheville">Andrea Cheville</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN</wicri:regionArea><wicri:noRegion>MN</wicri:noRegion></affiliation></author><author><name sortKey="Karaca Mandic, Pinar" sort="Karaca Mandic, Pinar" uniqKey="Karaca Mandic P" first="Pinar" last="Karaca-Mandic">Pinar Karaca-Mandic</name><affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN</wicri:regionArea><wicri:noRegion>MN</wicri:noRegion></affiliation></author><author><name sortKey="Rockson, Stanley G" sort="Rockson, Stanley G" uniqKey="Rockson S" first="Stanley G." last="Rockson">Stanley G. Rockson</name><affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Stanford Center for Lymphatic and Venous Disorders, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Stanford Center for Lymphatic and Venous Disorders, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Health Care Costs</term><term>Humans</term><term>Insurance, Health</term><term>Intermittent Pneumatic Compression Devices</term><term>Lymphedema (economics)</term><term>Lymphedema (epidemiology)</term><term>Lymphedema (therapy)</term><term>Male</term><term>Middle Aged</term><term>Neoplasms (economics)</term><term>Neoplasms (epidemiology)</term><term>Neoplasms (pathology)</term><term>Prevalence</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Assurance maladie</term><term>Coûts des soins de santé</term><term>Dispositifs à compression pneumatique intermittente</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Lymphoedème ()</term><term>Lymphoedème (économie)</term><term>Lymphoedème (épidémiologie)</term><term>Mâle</term><term>Prévalence</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Tumeurs (anatomopathologie)</term><term>Tumeurs (économie)</term><term>Tumeurs (épidémiologie)</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Lymphedema</term><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphedema</term><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Lymphoedème</term><term>Tumeurs</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Lymphoedème</term><term>Tumeurs</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Health Care Costs</term><term>Humans</term><term>Insurance, Health</term><term>Intermittent Pneumatic Compression Devices</term><term>Male</term><term>Middle Aged</term><term>Prevalence</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Assurance maladie</term><term>Coûts des soins de santé</term><term>Dispositifs à compression pneumatique intermittente</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Lymphoedème</term><term>Mâle</term><term>Prévalence</term><term>Résultat thérapeutique</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Lymphedema is a common complication of cancer therapeutics; its prevalence, treatment outcomes, and costs have been poorly defined. The objective of this study was to examine lymphedema prevalence among cancer survivors and to characterize changes in clinical outcomes and costs associated with a defined therapeutic intervention (use of a pneumatic compression devices [PCD]) in a representative, privately insured population.</p></sec><sec><title>Methods and Findings</title><p>Retrospective analysis of de-identified health claims data from a large national insurer for calendar years 2007 through 2013. Patients were required to have 12 months of continuous insurance coverage prior to PCD receipt (baseline), as well as a 12-month follow-up period. Analyses were performed for individuals with cancer-related lymphedema (n = 1,065). Lymphedema prevalence was calculated: number of patients with a lymphedema claim in a calendar year divided by total number of enrollees. The impact of PCD use was evaluated by comparing rates of a pre-specified set of health outcomes and costs for the 12 months before and after, respectively, PCD receipt. Lymphedema prevalence among cancer survivors increased from 0.95% in 2007 to 1.24% in 2013. PCD use was associated with decreases in rates of hospitalizations (45% to 32%, p<0.0001), outpatient hospital visits (95% to 90%, p<0.0001), cellulitis diagnoses (28% to 22%, p = 0.003), and physical therapy use (50% to 41%, p<0.0001). The average baseline health care costs were high ($53,422) but decreased in the year after PCD acquisition (−$11,833, p<0.0001).</p></sec><sec><title>Conclusions</title><p>Lymphedema is a prevalent medical condition that is often a defining attribute of cancer survivorship. The problem is associated with high health care costs; Treatment (in this instance, use of PCD) is associated with significant decreases in adverse clinical outcomes and costs.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Szuba, A" uniqKey="Szuba A">A Szuba</name></author><author><name sortKey="Shin, Ws" uniqKey="Shin W">WS Shin</name></author><author><name sortKey="Strauss, Hw" uniqKey="Strauss H">HW Strauss</name></author><author><name sortKey="Rockson, S" uniqKey="Rockson S">S Rockson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Radhakrishnan, K" uniqKey="Radhakrishnan K">K Radhakrishnan</name></author><author><name sortKey="Rockson, Sg" uniqKey="Rockson S">SG Rockson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Paskett, Ed" uniqKey="Paskett E">ED Paskett</name></author><author><name sortKey="Naughton, Mj" uniqKey="Naughton M">MJ 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Langan</name></author><author><name sortKey="Gray, Bh" uniqKey="Gray B">BH Gray</name></author><author><name sortKey="Johnson, B" uniqKey="Johnson B">B Johnson</name></author><author><name sortKey="Taylor, Sm" uniqKey="Taylor S">SM Taylor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eslami, Mh" uniqKey="Eslami M">MH Eslami</name></author><author><name sortKey="Zayaruzny, M" uniqKey="Zayaruzny M">M Zayaruzny</name></author><author><name sortKey="Fitzgerald, Ga" uniqKey="Fitzgerald G">GA Fitzgerald</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hillner, Be" uniqKey="Hillner B">BE Hillner</name></author><author><name sortKey="Mandelblatt, J" uniqKey="Mandelblatt J">J Mandelblatt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stout, Nl" uniqKey="Stout N">NL Stout</name></author><author><name sortKey="Weiss, R" uniqKey="Weiss R">R Weiss</name></author><author><name sortKey="Feldman, Jl" uniqKey="Feldman J">JL Feldman</name></author><author><name sortKey="Stewart, Br" uniqKey="Stewart B">BR Stewart</name></author><author><name sortKey="Armer, Jm" uniqKey="Armer J">JM Armer</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Brayton, Kimberly M" sort="Brayton, Kimberly M" uniqKey="Brayton K" first="Kimberly M." last="Brayton">Kimberly M. Brayton</name></region><name sortKey="Cheville, Andrea" sort="Cheville, Andrea" uniqKey="Cheville A" first="Andrea" last="Cheville">Andrea Cheville</name><name sortKey="Hirsch, Alan T" sort="Hirsch, Alan T" uniqKey="Hirsch A" first="Alan T." last="Hirsch">Alan T. Hirsch</name><name sortKey="Karaca Mandic, Pinar" sort="Karaca Mandic, Pinar" uniqKey="Karaca Mandic P" first="Pinar" last="Karaca-Mandic">Pinar Karaca-Mandic</name><name sortKey="O Rien, Patricia J" sort="O Rien, Patricia J" uniqKey="O Rien P" first="Patricia J." last="O Rien">Patricia J. O Rien</name><name sortKey="Rockson, Stanley G" sort="Rockson, Stanley G" uniqKey="Rockson S" first="Stanley G." last="Rockson">Stanley G. Rockson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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