title: Using comorbidity indexes to predict costs for head and neck cancer.
abstract: OBJECTIVE
  To determine whether the general Charlson Comorbidity Index (CCI) and the head and neck cancer-specific Washington University Head and Neck Cancer Comorbidity Index (WUHNCCI) were useful for predicting cost of treatment for elderly patients with head and neck cancer.
  
  
  METHODS
  Retrospective, observational study.
  
  
  METHODS
  A total of 1780 Medicare patients with head and neck cancer, who were treated between 1984 and 1994, were analyzed using the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database.
  
  
  METHODS
  Total Medicare payments were accumulated for each patient up to 1 and 5 years. Linear regression was used to estimate the impact of the comorbidity indexes on costs, controlling for demographics, site, stage, and treatment modality.
  
  
  RESULTS
  Neither the WUHNCCI nor the CCI was significantly associated with 1-year costs. However, the effect of the WUHNCCI on 5-year costs was statistically significant (P<.001). A 1-point increase in the WUHNCCI from 4 to 5 was associated with an increase in 5-year costs of $2105. A 1-point increase in the WUHNCCI from 9 to 10 was associated with an increase in 5-year costs of $2837.
  
  
  CONCLUSIONS
  These results suggest that comorbidity indexes for head and neck cancer may be useful for prognostication of patient outcomes and predicting costs.
authors.affiliation: Department of Surgery, Penn State College of Medicine, Hershey, PA 17033, USA. chollenbeak@psu.edu
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hollenbeak
authors.forename: Brendan C
authors.initials: BC
authors.lastname: Stack
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Daley
authors.forename: Jay F
authors.initials: JF
authors.lastname: Piccirillo
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000191:economics*; D015897:Comorbidity; D005260:Female; D006258:Head and Neck Neoplasms / Q000191:economics*; D006801:Humans; D008297:Male; D006278:Medicare; D012189:Retrospective Studies; D014481:United States