title: End-of-Life Medical Costs of Medicaid Cancer Patients.
abstract: OBJECTIVE
  To quantify end-of-life (EOL) medical costs for adult Medicaid beneficiaries diagnosed with cancer.
  
  
  METHODS
  We linked Medicaid administrative data with 2000-2003 cancer registry data to identify 3,512 adult Medicaid beneficiaries who died after a cancer diagnosis and matched them to a cohort of beneficiaries without cancer who died during the same period.
  
  
  METHODS
  We used multivariable regression analysis to estimate incremental per-person EOL cost after controlling for beneficiaries' age, race/ethnicity, sex, cancer site, and state of residence.
  
  
  RESULTS
  End-of-life costs during the final 4 months of life were about $10,000 higher for Medicaid cancer patients than for those without cancer. Medicaid cancer patients are more intensive users of inpatient and ambulatory services than are Medicaid patients without cancer. Medicaid cancer patients who die soon after diagnosis have higher costs of care and use inpatient services more intensely than do Medicaid patients without cancer.
  
  
  CONCLUSIONS
  Medicaid cancer patients incur substantially higher EOL costs than noncancer patients. This increased cost may reflect the cost of palliative care. Future studies should assess the types and timing of services provided to Medicaid cancer patients at the EOL.
authors.affiliation: Division of Cancer Prevention and Control, CDC, 4770 Buford Highway, NE, MS F-76, Atlanta, GA.
authors.forename: Florence K L
authors.initials: FK
authors.lastname: Tangka
authors.affiliation: RTI International, Waltham, MA.
authors.forename: Sujha
authors.initials: S
authors.lastname: Subramanian
authors.affiliation: Division of Cancer Prevention and Control, CDC, 4770 Buford Highway, NE, MS F-76, Atlanta, GA.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Sabatino
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: David H
authors.initials: DH
authors.lastname: Howard
authors.affiliation: RTI International, Waltham, MA.
authors.forename: Susan
authors.initials: S
authors.lastname: Haber
authors.affiliation: RTI International, Waltham, MA.
authors.forename: Sonja
authors.initials: S
authors.lastname: Hoover
authors.affiliation: Division of Cancer Prevention and Control, CDC, 4770 Buford Highway, NE, MS F-76, Atlanta, GA.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Richardson
mesh_terms: D000328:Adult; D003365:Costs and Cost Analysis; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D017059:Models, Econometric; D009369:Neoplasms / Q000191:economics*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013727:Terminal Care / Q000191:economics*; D013997:Time Factors; D014481:United States
keywords: Econometrics; Medicaid; cancer; chronic disease; end-of-life cost; health care costs