title: Annual patient time costs associated with medical care among cancer survivors in the United States.
abstract: BACKGROUND
  Although patient time costs are recommended for inclusion in cost-effectiveness analyses, these data are not routinely collected. We used nationally representative data and a medical service-based approach to estimate the annual patient time costs among cancer survivors.
  
  
  METHODS
  We identified adult 6699 cancer survivors and 86,412 individuals without a cancer history ages 18 years or more from 2008-2011 Medical Expenditure Panel Survey (MEPS). Service use was categorized as hospitalizations, emergency room use, provider visits, ambulatory surgery, chemotherapy, and radiation therapy. Service time estimates were applied to frequencies for each service category and the US median wage rate in 2011 was used to value time. We evaluated the association between cancer survivorship and service use frequencies and patient time costs with multivariable regression models, stratified by age group (18-64 and 65+ y). Sensitivity analyses evaluated different approaches for valuing time.
  
  
  RESULTS
  Cancer survivors were more likely to have hospitalizations, emergency room visits, ambulatory surgeries, and provider visits in the past year than individuals without a cancer history in adjusted analyses (P<0.05). Annual patient time was higher for cancer survivors than individuals without a cancer history among those aged 18-64 years (30.2 vs. 13.6 h; P<0.001) and 65+ years (55.1 vs. 36.6 h; P<0.001), as were annual patient time costs (18-64 y: $500 vs. $226; P<0.001 and 65+ y: $913 vs. $607; P<0.001).
  
  
  CONCLUSIONS
  Cancer survivors had greater annual medical service use and patient time costs than individuals without a cancer history. This medical service-based approach for estimating annual time costs can also be applied to other conditions.
authors.affiliation: *Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD †Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA ‡Information Management Services. Inc Rockville, MD §Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA ∥Department of Health Policy and Management, Emory University, Atlanta, GA.
authors.forename: K Robin
authors.initials: KR
authors.lastname: Yabroff
authors.forename: Gery P
authors.initials: GP
authors.lastname: Guy
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.forename: Timothy
authors.initials: T
authors.lastname: McNeel
authors.forename: Heather M
authors.initials: HM
authors.lastname: Rozjabek
authors.forename: Emily
authors.initials: E
authors.lastname: Dowling
authors.forename: Chunyu
authors.initials: C
authors.lastname: Li
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Virgo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D005260:Female; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics*; D012959:Socioeconomic Factors; D017741:Survivors / Q000706:statistics & numerical data*; D013995:Time; D014195:Travel / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult