Pricing of surgeries for colon cancer: patient severity and market factors.

Cancer
Avi DorGregory Cooper

Abstract

This study examined effects of health maintenance organization (HMO) penetration, hospital competition, and patient severity on the uptake of laparoscopic colectomy and its price relative to open surgery for colon cancer. The MarketScan Database (data from 2002-2007) was used to identify admissions for privately insured colorectal cancer patients undergoing laparoscopic or open partial colectomy (n = 1035 and n = 6389, respectively). Patient and health plan characteristics were retrieved from these data; HMO market penetration rates and an index of hospital market concentration, the Herfindahl-Hirschman index (HHI), were derived from national databases. Logistic and logarithmic regressions were used to examine the odds of having laparoscopic colectomy, effect of covariates on colectomy prices, and the differential price of laparoscopy. Adoption of laparoscopy was highly sensitive to market forces, with a 10% increase in HMO penetration leading to a 10.9% increase in the likelihood of undergoing laparoscopic colectomy (adjusted odds ratio = 1.109; 95% confidence interval [CI] = 1.062, 1.158) and a 10% increase in HHI resulting in 6.6% lower likelihood (adjusted odds ratio = 0.936; 95% CI = 0.880, 0.996). Price models indicated t...Continue Reading

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Citations

Mar 29, 2014·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jeffrey HammondAnuprita Patkar
May 21, 2013·Journal of Vascular Surgery·Rosh K V SethiLouis L Nguyen
Jun 1, 2015·The Journal of Surgical Research·Afif N KulaylatNiraj J Gusani
Sep 3, 2020·Journal of Robotic Surgery·Aaron C SpauldingDorin T Colibaseanu
Oct 18, 2018·Annals of Surgical Oncology·Jason D WrightDawn L Hershman
Feb 20, 2020·MDM Policy & Practice·Chan ShenPeter Dillon
Nov 26, 2019·Health Services Research and Managerial Epidemiology·Sung W Choi, Avi Dor
Mar 9, 2021·Plastic and Reconstructive Surgery. Global Open·Kenneth L FanDerek DeLia
Mar 8, 2021·The Lancet Oncology·Ajay AggarwalJan van der Meulen

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