Influence of Health and Functional Status and Co-occurring Chronic Conditions on Healthcare Expenditures Among Community-dwelling Adults With Kidney Cancer in the United States: A Propensity–score-matched Analysis

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Abstract

Micro-Abstract

The influence of health and functional status as well as chronic conditions on healthcare expenditures among survivors of kidney cancer are unknown. A retrospective, cross-sectional, propensity–score-matched, case-control study design was used to answer this question. Adults with kidney cancer had significantly higher healthcare expenditures compared with matched controls, and these factors had significant influence on their healthcare expenditures.

Background:

Health and functional status, as well as co-occurring chronic conditions, have a profound influence on healthcare expenditures. However, no study to date has assessed their influence among community-dwelling adults with kidney cancer (KC) in the United States (US). This study assessed the impact of health and functional status, along with co-occurring chronic conditions, on KC healthcare expenditures.

Methods:

This study used a retrospective, cross-sectional, propensity–score-matched, case-control study design using 2002 to 2011 Medical Expenditure Panel Survey data. The case group was comprised of adults with KC, whereas the control group consisted of propensity-score matched adults with other forms of cancer. To examine the impact of health and functional status and co-occurring chronic conditions, ordinary least square regressions on log-transformed expenditures were conducted on total and subtypes of healthcare expenditures. The percentage change in expenditure was calculated using the formula (expβ − 1).

Results:

Findings from this study indicate that the annual average total healthcare expenditures ($15,078 vs. $8182; P < .001) for adults with KC were significantly higher compared with propensity–score-matched adults with other forms of cancer. Total healthcare expenditures for adults with KC were 80% (β = 0.588; P < .001) higher compared with propensity–score-matched controls when only demographic characteristics were adjusted. After adjusting for health and functional status and co-occurring chronic conditions, the percentage decreased from 80% to 43% (β = 0.359; P < .01).

Conclusions:

Findings from this nationally representative sample suggest that health and functional status and co-occurring chronic conditions have a significant impact on healthcare expenditures among community-dwelling adults with KC in the US.

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