title: Characterizing medical care by disease phase in metastatic colorectal cancer.
abstract: OBJECTIVE
  To characterize patterns of medical care by disease phase in patients with newly diagnosed metastatic colorectal cancer (mCRC).
  
  
  METHODS
  Patients with mCRC newly diagnosed between 2004 and 2008 were selected from a large US national commercially insured claims database and were observed from initial mCRC diagnosis to death, disenrollment, or end of study period (July 31, 2009), whichever occurred first. The observation period was divided into 3 distinct phases of disease: diagnostic, treatment, and death. Within each phase, patterns of medical care were examined by the mutually exclusive service categories of inpatient, emergency department (ED), outpatient office and facility, outpatient pharmacy, chemotherapy, and biologic therapy, as measured by estimation of aggregate and category costs per patient per month.
  
  
  RESULTS
  A total of 6675 patients with newly diagnosed mCRC were analyzed. Mean age was 64.1 years; 55.5% were males. Mean costs per patient per month for diagnostic, treatment, and death phases were $16,895, $8891, and $27,554, respectively. Inpatient care was the primary driver of medical care for both the diagnostic (41.7% of costs) and death (71.4% of costs) phases. The largest category of medical care for the treatment phase was outpatient care (45.0% of costs). Chemotherapy and biologic therapy accounted for 15.6% and 17.6% of costs in the treatment phase, respectively.
  
  
  CONCLUSIONS
  Substantial differences in patterns of medical care were found between mCRC disease phases. Inpatient care was the key driver of medical care in the diagnostic and death phases compared with outpatient care in the treatment phase.
authors.affiliation: Thomson Reuters, 4301 Connecticut Ave, Washington, DC 20008, USA. xue.song@thomsonreuters.com
authors.forename: Xue
authors.initials: X
authors.lastname: Song
authors.forename: Zhongyun
authors.initials: Z
authors.lastname: Zhao
authors.forename: Beth
authors.initials: B
authors.lastname: Barber
authors.forename: Christopher
authors.initials: C
authors.lastname: Gregory
authors.forename: David
authors.initials: D
authors.lastname: Schutt
authors.forename: Sue
authors.initials: S
authors.lastname: Gao
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000191:economics* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D019992:Databases as Topic; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D005791:Patient Care / Q000145:classification*
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents