Observation interval for evaluating the costs of surgical interventions for older women with a new diagnosis of breast cancer

Medical Care
C GivenJ R Osuch

Abstract

To estimate the episodic costs of surgical treatments for breast cancer. The surgical treatment period as the 6 weeks following diagnosis is defined. Using a sample of 205 women aged 65 and older and their Medicare claim files, the cost of treatment is estimated and the progression from first to subsequent surgical procedures during the 6-week interval is demonstrated with a decision tree. Two equations are then estimated: the probability of mastectomy versus breast conserving surgery (BCS) as first surgery using Probit regression and the log of total charges using a generalized linear regression model. It was found that only stage predicts the probability of mastectomy versus BCS and that 54% of women receiving BCS undergo a second surgery. Once all treatments in the initial surgical period are accounted, the difference between the adjusted cost of mastectomy alone and BCS followed by a second surgery was not statistically significant. Only a successful first BCS is statistically significantly (P <0.05) less costly than a mastectomy alone ($4,955 vs. $9,049). By defining a 6-week surgical treatment episode it is shown that BCS followed by subsequent surgeries is the more costly option for initial treatment. Given the high prev...Continue Reading

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Citations

Oct 30, 2007·Nature Clinical Practice. Oncology·K Robin YabroffMartin L Brown
Jun 22, 2007·Critical Care Medicine·Carolyn Bekes
Jun 4, 2011·Implementation Science : IS·Shannon D ScottTerry P Klassen
Mar 29, 2012·Implementation Science : IS·Kate SeersLars Wallin
Aug 30, 2012·Implementation Science : IS·Veronique M BoscartSusan B Jaglal
Apr 10, 2009·PharmacoEconomics·Jonathan D Campbell, Scott D Ramsey
Dec 27, 2011·Health Services & Outcomes Research Methodology·Anirban BasuWillard G Manning
Mar 15, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Daniel PolskyKevin A Schulman
Jun 4, 2008·British Journal of Cancer·G Lewison, R Sullivan
Oct 17, 2006·Worldviews on Evidence-based Nursing·Jo Rycroft-Malone

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