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- Title
Dartmouth Atlas Area-Level Estimates of End-of-Life Expenditures: How Well Do They Reflect Expenditures for Prospectively Identified Advanced Lung Cancer Patients?
- Authors
Keating, Nancy L.; Landrum, Mary Beth; Huskamp, Haiden A.; Kouri, Elena M.; Prigerson, Holly G.; Schrag, Deborah; Maciejewski, Paul K.; Hornbrook, Mark C.; Haggstrom, David A.
- Abstract
<bold>Objective: </bold>Assess validity of the retrospective Dartmouth hospital referral region (HRR) end-of-life spending measures by comparing with health care expenditures from diagnosis to death for prospectively identified advanced lung cancer patients.<bold>Data/setting/design: </bold>We calculated health care spending from diagnosis (2003-2005) to death or through 2011 for 885 patients aged ≥65 years with advanced lung cancer using Medicare claims. We assessed the association between Dartmouth HRR-level spending in the last 2 years of life and patient-level spending using linear regression with random HRR effects, adjusting for patient characteristics.<bold>Findings: </bold>For each $1 increase in the Dartmouth metric, spending for our cohort increased by $0.74 (p < .001). The Dartmouth spending variable explained 93.4 percent of the HRR-level variance in observed spending.<bold>Conclusions: </bold>HRR-level spending estimates for deceased patient cohorts reflect area-level care intensity for prospectively identified advanced lung cancer patients.
- Subjects
CANCER patients; RECREATION for cancer patients; CANCER clusters; LUNG cancer; CONDUCT of life
- Publication
Health Services Research, 2016, Vol 51, Issue 4, p1584
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.12440