SURVIVAL, HEALTHCARE UTILIZATION, AND COSTS ASSOCIATED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AMONG SEER-MEDICARE BENEFICIARIES WITH NON-SMALL CELL LUNG CANCER

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Shah, S. (2017). SURVIVAL, HEALTHCARE UTILIZATION, AND COSTS ASSOCIATED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AMONG SEER-MEDICARE BENEFICIARIES WITH NON-SMALL CELL LUNG CANCER. Unc Charlotte Electronic Theses And Dissertations.
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Abstract

ABSTRACTSHWETA SHAH. Survival, healthcare utilization and costs associated with chronic obstructive pulmonary disease among SEER-Medicare beneficiaries with non-small cell lung cancer. (Under the direction of DR. CHRISTOPHER M. BLANCHETTE)Lung cancer and chronic obstructive pulmonary disease (COPD) are among leading causes of morbidity and mortality worldwide. We investigated the impact of pre-existing COPD and its subtypes, chronic bronchitis and emphysema, on overall survival among Medicare enrollees diagnosed with non-small cell lung cancer (NSCLC). We also assessed healthcare utilization and costs in elderly NSCLC patients with and without pre-existing COPD. Using SEER-Medicare data, we included patients >= 66 years of age diagnosed with NSCLC at any disease stage between 2006 to 2010 and continuously enrolled in Medicare Parts A and B in the 12 months prior to diagnosis. Pre-existing COPD in patients with NSCLC were identified using ICD-9 codes. Kaplan-Meier method and log-rank tests were used to examine overall survival by COPD status and COPD subtype. Multivariable Cox Proportional Hazards models were fit to assess the risk of death after cancer diagnosis. The adjusted analysis was performed using a generalized linear model for healthcare costs and a negative binomial model for healthcare utilization. NSCLC patients with pre-existing COPD had shorter survival with marked differences in early stages of cancer. Chronic bronchitis demonstrated a greater association with time to death than emphysema. Healthcare utilization and costs among lung cancer patients with pre-existing COPD was approximately two to three times higher than the Non-COPD group.

Details
Author

Shah, Shweta

Title

SURVIVAL, HEALTHCARE UTILIZATION, AND COSTS ASSOCIATED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AMONG SEER-MEDICARE BENEFICIARIES WITH NON-SMALL CELL LUNG CANCER

Physical Description

1 online resource (98 pages) : PDF

Date

2017

Degree Granting Institution

University of North Carolina at Charlotte

Abstract

ABSTRACTSHWETA SHAH. Survival, healthcare utilization and costs associated with chronic obstructive pulmonary disease among SEER-Medicare beneficiaries with non-small cell lung cancer. (Under the direction of DR. CHRISTOPHER M. BLANCHETTE)Lung cancer and chronic obstructive pulmonary disease (COPD) are among leading causes of morbidity and mortality worldwide. We investigated the impact of pre-existing COPD and its subtypes, chronic bronchitis and emphysema, on overall survival among Medicare enrollees diagnosed with non-small cell lung cancer (NSCLC). We also assessed healthcare utilization and costs in elderly NSCLC patients with and without pre-existing COPD. Using SEER-Medicare data, we included patients >= 66 years of age diagnosed with NSCLC at any disease stage between 2006 to 2010 and continuously enrolled in Medicare Parts A and B in the 12 months prior to diagnosis. Pre-existing COPD in patients with NSCLC were identified using ICD-9 codes. Kaplan-Meier method and log-rank tests were used to examine overall survival by COPD status and COPD subtype. Multivariable Cox Proportional Hazards models were fit to assess the risk of death after cancer diagnosis. The adjusted analysis was performed using a generalized linear model for healthcare costs and a negative binomial model for healthcare utilization. NSCLC patients with pre-existing COPD had shorter survival with marked differences in early stages of cancer. Chronic bronchitis demonstrated a greater association with time to death than emphysema. Healthcare utilization and costs among lung cancer patients with pre-existing COPD was approximately two to three times higher than the Non-COPD group.

Genre

doctoral dissertations

Subjects--Topics

Epidemiology
Medical sciences

Degree

Ph.D.

Keywords

Cost
Health Economics
Lung Cancer
Outcomes Research
Survival
Utilization

Subject Area

Health Services Research

Advisor(s)

Blanchette, Christopher

Committee Members

Coyle, Joseph
Arthur, Susan
Kowalkowski, Marc
Howden, Reuben

Degree Note

Thesis (Ph.D.)--University of North Carolina at Charlotte, 2017.

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Rights Holder Information

Copyright is held by the author unless otherwise indicated.

Identifier

Shah_uncc_0694D_11327

Permalink

http://hdl.handle.net/20.500.13093/etd:1182