Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis
Objective We study how clinical and socioeconomic factors influence colorectal cancer (CRC) costs for patients and Medicare in Australia. The study seeks to extend the limited Australian literature on CRC costs by analysing comprehensive patient-level medical services and pharmaceutical cost data.De...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e081483.full |
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| author | Sallie-Anne Pearson Peter Gibbs David Roder Jayesh Desai Fanny Franchini Marliese Alexander Yuting Zhang Adam Elshaug David Attwood Stephen Fox Sean Grimmond Ou Yang Yat Hang To Maarten M J IJzerman Judith Liu Karen Trapani Koen Degeling Grant McArthur Ben Solomon Sophy Athan Paul Baden Wendy Benson Catherine Bressanutti George Jiang Carolyn Rowan |
| author_facet | Sallie-Anne Pearson Peter Gibbs David Roder Jayesh Desai Fanny Franchini Marliese Alexander Yuting Zhang Adam Elshaug David Attwood Stephen Fox Sean Grimmond Ou Yang Yat Hang To Maarten M J IJzerman Judith Liu Karen Trapani Koen Degeling Grant McArthur Ben Solomon Sophy Athan Paul Baden Wendy Benson Catherine Bressanutti George Jiang Carolyn Rowan |
| author_sort | Sallie-Anne Pearson |
| collection | DOAJ |
| description | Objective We study how clinical and socioeconomic factors influence colorectal cancer (CRC) costs for patients and Medicare in Australia. The study seeks to extend the limited Australian literature on CRC costs by analysing comprehensive patient-level medical services and pharmaceutical cost data.Design, setting and participants Using the Victorian Cancer Registry, we identified all patients in Victoria who were diagnosed with CRC from 2010 to 2019 and extracted their linked 2010–2021 Medicare data. This data includes expenses from the Pharmaceutical Benefits Scheme and Medicare Benefits Schedule services. We examined variables such as disease stage, CRC type, molecular profile, metastasis status and demographics (eg, age, birth country, socioeconomic level via the SEIFA index, and native language). We applied descriptive and log-linear multivariate regression analyses to explore patient and Medicare costs related to CRC treatment.Results Costs significantly rise with advanced cancer stages, especially on medication costs. Patients’ average out-of-pocket (OOP) expenses are roughly $A441 per year. Key cost influencers are gender, age and socioeconomic status. On average, males incur 13.5% higher annual costs, a significantly larger OOP expense, than females. Compared with patients aged 50 or below, there is a 7.1% cost increase for individuals aged 50–70 and an 8.8% decrease post-70, likely reflecting less intensive treatment for the elderly. Socioeconomic factors show a clear gradient. Wealthier areas experience higher costs, especially among native English speakers. Costs also vary based on cancer’s anatomical location and specific genetic mutations.Conclusion The research highlights that CRC treatment expenses for patients and Medicare differ considerably due to factors such as diagnostic stage, demographics, anatomical location of the tumour and mutations. These cost variations lead to concerns about healthcare equality and decision-making autonomy. Policymakers may need to focus on early detection, increased support for advanced-stage patients, gender-sensitive healthcare, and equitable access to treatment across different socioeconomic groups. |
| format | Article |
| id | doaj-art-a6cf35fd7df34a859d3620c25ae609aa |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a6cf35fd7df34a859d3620c25ae609aa2024-12-17T10:00:15ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2023-081483Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysisSallie-Anne Pearson0Peter Gibbs1David RoderJayesh DesaiFanny Franchini2Marliese AlexanderYuting Zhang3Adam ElshaugDavid AttwoodStephen FoxSean GrimmondOu Yang4Yat Hang To5Maarten M J IJzerman6Judith Liu7Karen Trapani8Koen DegelingGrant McArthur Ben SolomonSophy AthanPaul BadenWendy BensonCatherine BressanuttiGeorge JiangCarolyn Rowan1University of New South Wales, Sydney2 Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia3 Centre for Health Policy, The University of Melbourne, Melbourne, Victoria, Australia1 Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Melbourne, Victoria, Australia1 Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Melbourne, Victoria, Australia2 Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia3 Centre for Health Policy, The University of Melbourne, Melbourne, Victoria, Australia5 Department of Economics, University of Oklahoma, Norman, Queensland, USA3 Centre for Health Policy, The University of Melbourne, Melbourne, Victoria, AustraliaObjective We study how clinical and socioeconomic factors influence colorectal cancer (CRC) costs for patients and Medicare in Australia. The study seeks to extend the limited Australian literature on CRC costs by analysing comprehensive patient-level medical services and pharmaceutical cost data.Design, setting and participants Using the Victorian Cancer Registry, we identified all patients in Victoria who were diagnosed with CRC from 2010 to 2019 and extracted their linked 2010–2021 Medicare data. This data includes expenses from the Pharmaceutical Benefits Scheme and Medicare Benefits Schedule services. We examined variables such as disease stage, CRC type, molecular profile, metastasis status and demographics (eg, age, birth country, socioeconomic level via the SEIFA index, and native language). We applied descriptive and log-linear multivariate regression analyses to explore patient and Medicare costs related to CRC treatment.Results Costs significantly rise with advanced cancer stages, especially on medication costs. Patients’ average out-of-pocket (OOP) expenses are roughly $A441 per year. Key cost influencers are gender, age and socioeconomic status. On average, males incur 13.5% higher annual costs, a significantly larger OOP expense, than females. Compared with patients aged 50 or below, there is a 7.1% cost increase for individuals aged 50–70 and an 8.8% decrease post-70, likely reflecting less intensive treatment for the elderly. Socioeconomic factors show a clear gradient. Wealthier areas experience higher costs, especially among native English speakers. Costs also vary based on cancer’s anatomical location and specific genetic mutations.Conclusion The research highlights that CRC treatment expenses for patients and Medicare differ considerably due to factors such as diagnostic stage, demographics, anatomical location of the tumour and mutations. These cost variations lead to concerns about healthcare equality and decision-making autonomy. Policymakers may need to focus on early detection, increased support for advanced-stage patients, gender-sensitive healthcare, and equitable access to treatment across different socioeconomic groups.https://bmjopen.bmj.com/content/14/12/e081483.full |
| spellingShingle | Sallie-Anne Pearson Peter Gibbs David Roder Jayesh Desai Fanny Franchini Marliese Alexander Yuting Zhang Adam Elshaug David Attwood Stephen Fox Sean Grimmond Ou Yang Yat Hang To Maarten M J IJzerman Judith Liu Karen Trapani Koen Degeling Grant McArthur Ben Solomon Sophy Athan Paul Baden Wendy Benson Catherine Bressanutti George Jiang Carolyn Rowan Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis BMJ Open |
| title | Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis |
| title_full | Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis |
| title_fullStr | Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis |
| title_full_unstemmed | Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis |
| title_short | Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis |
| title_sort | effects of clinical and socioeconomic factors on medicare and patient costs for colorectal cancer in australia a retrospective multivariate regression analysis |
| url | https://bmjopen.bmj.com/content/14/12/e081483.full |
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