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Text
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URL Address
<a href="http://doi.org/10.1016/j.ygyno.2005.07.102" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.ygyno.2005.07.102</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Resource utilization for ovarian cancer patients at the end of life: how much is too much?
Publisher
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Gynecologic Oncology
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Female; Humans; Adult; Medical Futility; Aged; Middle Aged; 80 and over; Comparative Study; retrospective studies; Hospice Care/economics; Health Services/economics/utilization; Hospitalization/economics; Ovarian Neoplasms/economics/therapy; Palliative Care/economics; Terminal Care/economics/methods
Creator
An entity primarily responsible for making the resource
Lewin SN; Buttin BM; Powell MA; Gibb RK; Rader JS; Mutch DG; Herzog TJ
Description
An account of the resource
OBJECTIVE: End-of-life (EOL) medical care consumes 10-12% of national health care expenditures and 27% of Medicare dollars annually. Studies suggest that hospice services decrease EOL expenditures by 25-40%. The goal of this study was to compare the total cost of hospital-based resources utilized in ovarian cancer patients during their last 60 days of life for those enrolled in hospice versus those not on hospice. METHODS: Study eligibility included patients who expired from ovarian cancer from 1999 to 2003. Medical records were reviewed for demographic data as well as treatment, response and recurrence rates, histologic type, grade and stage. Billing records were analyzed for costs of inpatient and outpatients visits, including radiologic, laboratory and pharmacy charges. Total cost of hospital resources was compared between patients managed on hospice for >10 days (hospice group) versus <10 days (non-hospice group) using the following methods: Mann-Whitney U, Kruskal-Wallis and Student's t tests. Overall survival was compared using Kaplan-Meier statistics. RESULTS: Of the 84 patients analyzed, 67 (79.8%) were in the non-hospice group and 17 (20.2%) were in the hospice group. Demographic, histologic and staging characteristics as well as platinum sensitivity were similar between the two groups before the last 60 days of life. Mean number of chemotherapy cycles before the study period was also similar (20.4 and 21.0, respectively). However, during the study period, the mean total cost per patient in the non-hospice group was dollar 59,319 versus dollar 15,164 in the hospice group (P = 0.0001). A significant difference in cost was noted for mean inpatient days (dollar 6584 vs. dollar 1629, P = 0.0007), radiology (dollar 6063 vs. dollar 2343, P = 0.003), laboratory (dollar 12,281 vs. dollar 2026, P = 0.0004) and pharmacy charges (dollar 13,650 vs. dollar 4465, P = 0.0017) as well as for treating physician per patient (dollar 112,707 vs. dollar 34,677, P = 0.04). Overall survival for the two groups was the same. CONCLUSIONS: Our findings demonstrate that there is a significant cost difference with no appreciable improvement in survival between ovarian cancer patients treated aggressively versus those enrolled in hospice at the EOL. These data suggest that earlier hospice enrollment is beneficial. Furthermore, cost variations between physicians and patients imply that education may be an important variable.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.ygyno.2005.07.102" target="_blank" rel="noreferrer">10.1016/j.ygyno.2005.07.102</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2005
80 And Over
Adult
Aged
Backlog
Buttin BM
Comparative Study
Female
Gibb RK
Gynecologic Oncology
Health Services/economics/utilization
Herzog TJ
Hospice Care/economics
Hospitalization/economics
Humans
Journal Article
Lewin SN
Medical Futility
Middle Aged
Mutch DG
Ovarian Neoplasms/economics/therapy
Palliative Care/economics
Powell MA
Rader JS
Retrospective Studies
Terminal Care/economics/methods
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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URL Address
<a href="http://doi.org/10.1016/j.jpainsymman.2004.05.003" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.jpainsymman.2004.05.003</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Medicare cost in matched hospice and non-hospice cohorts
Publisher
An entity responsible for making the resource available
Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Female; Humans; Male; Survival Rate; Cohort Studies; Aged; Middle Aged; Health Care Costs; Heart Failure; Case-Control Studies; 80 and over; Medicare/economics; Alzheimer Disease/economics/mortality/therapy; Cerebrovascular Accident/economics/mortality/therapy; Congestive/economics/mortality/therapy; Hospice Care/economics; Neoplasms/economics/mortality/therapy
Creator
An entity primarily responsible for making the resource
Pyenson B; Connor S; Fitch K; Kinzbrunner B
Description
An account of the resource
Hospice care is perceived as enhancing life quality for patients with advanced, incurable illness, but cost comparisons to non-hospice patients are difficult to make. The very large Medicare expenditures for care given during the end of life, combined with the pressure on Medicare spending, make this information important. We sought to identify cost differences between patients who do and do not elect to receive Medicare-paid hospice benefits. We introduce an innovative prospective/retrospective case-control method that we used to study 8,700 patients from a sample of 5% of the entire Medicare beneficiary population for 1999-2000 associated with 16 narrowly defined indicative markers. For the majority of cohorts, mean and median Medicare costs were lower for patients enrolled in hospice care. The lower costs were not associated with shorter duration until death. For important terminal medical conditions, including non-cancers, costs are lower for patients receiving hospice care. The lower cost is not associated with shorter time until death, and appears to be associated with longer mean time until death.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jpainsymman.2004.05.003" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2004.05.003</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2004
80 And Over
Aged
Alzheimer Disease/economics/mortality/therapy
Backlog
Case-Control Studies
Cerebrovascular Accident/economics/mortality/therapy
Cohort Studies
Congestive/economics/mortality/therapy
Connor S
Female
Fitch K
Health Care Costs
Heart Failure
Hospice Care/economics
Humans
Journal Article
Journal of Pain and Symptom Management
Kinzbrunner B
Male
Medicare/economics
Middle Aged
Neoplasms/economics/mortality/therapy
Pyenson B
Survival Rate