SURVIVAL, HEALTHCARE UTILIZATION, AND COSTS ASSOCIATED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AMONG SEER-MEDICARE BENEFICIARIES WITH NON-SMALL CELL LUNG CANCER
1 online resource (98 pages) : PDF
University of North Carolina at Charlotte
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.
COSTHEALTH ECONOMICSLUNG CANCEROUTCOMES RESEARCHSURVIVALUTILIZATION
Health Services Research
Coyle, JosephArthur, SusanKowalkowski, MarcHowden, Reuben
Thesis (Ph.D.)--University of North Carolina at Charlotte, 2017.
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