Cost of patient follow-up after potentially curative lung cancer treatment.
The two objectives of this study were to determine the range of recommended follow-up strategies for patients with lung cancer treated with curative intent and to estimate the cost of such follow-up. Ten articles delineating eight specific follow-up strategies were identified from a Medline search of the literature for 1980 through 1995. An economic analysis was done of the costs associated with the identified strategies. Charge data obtained from the Part B Medicare Annual Data file and the Hospital Outpatient Bill file were used as a proxy for cost. Follow-up intensity varied widely across strategies for 5 years of posttreatment follow-up. Medicare-allowed charges for 5-year follow-up ranged from a low of $946 to a high of $5645. When Medicare-allowed charges were converted to a proxy for actual charges by a conversion ratio of 1.62, the range was $1533 to $9145, a fivefold difference in charges. There was no indication that more intensive, higher-cost strategies increased survival or quality of life. The published literature, including textbooks, holds few answers in this area.
Virgo
K S
KS
Department of Surgery, St. Louis University Health Sciences Center, MO 63110-0250, USA.
Naunheim
K S
KS
McKirgan
L W
LW
Kissling
M E
ME
Lin
J C
JC
Johnson
F E
FE
D001774:Blood Chemical Analysis / Q000191:economics; D019411:Clinical Laboratory Techniques / Q000191:economics; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D005500:Follow-Up Studies; D017722:Hospital Charges; D017721:Hospital Costs; D006801:Humans; D008175:Lung Neoplasms / Q000191:economics* / Q000628:therapy*; D006278:Medicare / Q000191:economics; D016345:Medicare Part B / Q000191:economics; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary / Q000191:economics / Q000628:therapy; D009819:Office Visits / Q000191:economics; D011446:Prospective Studies; D011788:Quality of Life; D013902:Radiography, Thoracic / Q000191:economics; D012189:Retrospective Studies; D013183:Sputum; D014481:United States