title: Influence of Health and Functional Status and Co-occurring Chronic Conditions on Healthcare Expenditures Among Community-dwelling Adults With Kidney Cancer in the United States: A Propensity-score-matched Analysis.
abstract: Health and functional status, as well as co-occurring chronic conditions, have a profound influence on healthcare expenditures. However, no study to date has assessed their influence among community-dwelling adults with kidney cancer (KC) in the United States (US). This study assessed the impact of health and functional status, along with co-occurring chronic conditions, on KC healthcare expenditures.
  
  
  
  This study used a retrospective, cross-sectional, propensity-score-matched, case-control study design using 2002 to 2011 Medical Expenditure Panel Survey data. The case group was comprised of adults with KC, whereas the control group consisted of propensity-score matched adults with other forms of cancer. To examine the impact of health and functional status and co-occurring chronic conditions, ordinary least square regressions on log-transformed expenditures were conducted on total and subtypes of healthcare expenditures. The percentage change in expenditure was calculated using the formula (expβ- 1).
  
  
  
  Findings from this study indicate that the annual average total healthcare expenditures ($15,078 vs. $8182; P < .001) for adults with KC were significantly higher compared with propensity-score-matched adults with other forms of cancer. Total healthcare expenditures for adults with KC were 80% (β = 0.588; P < .001) higher compared with propensity-score-matched controls when only demographic characteristics were adjusted. After adjusting for health and functional status and co-occurring chronic conditions, the percentage decreased from 80% to 43% (β = 0.359; P < .01).
  
  
  
  Findings from this nationally representative sample suggest that health and functional status and co-occurring chronic conditions have a significant impact on healthcare expenditures among community-dwelling adults with KC in the US.
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ. Electronic address: bhattacharjee@pharmacy.arizona.edu.
authors.forename: Sandipan
authors.initials: S
authors.lastname: Bhattacharjee
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Gharaibeh
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital, Mount Sinai School of Medicine, Bronx, NY.
authors.forename: Muhammad Umar
authors.initials: MU
authors.lastname: Kamal
authors.affiliation: Department of Medicine, University of Arizona, Tucson, AZ.
authors.forename: Irbaz Bin
authors.initials: IB
authors.lastname: Riaz
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease / Q000191:economics*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007680:Kidney Neoplasms / Q000191:economics*; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
keywords: Activities disability; Activities of daily living limitations; Instrumental activities of daily living limitations; Mental health status