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Cancer. 2014 Apr 1;120(7):1050-8. doi: 10.1002/cncr.28537. Epub 2013 Dec 30.

National trends in pancreatic cancer outcomes and pattern of care among Medicare beneficiaries, 2000 through 2010.

Author information

1
Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts.

Abstract

BACKGROUND:

Pancreatic cancer is a major cause of morbidity and mortality in the Medicare population. Whether the health care burden of pancreatic cancer has changed over the last decade is unknown.

METHODS:

The authors used Medicare data from 2000 to 2010 to identify beneficiaries aged ≥ 65 years who were hospitalized for the management of pancreatic cancer. Annual trends were estimated for the age-sex-race-adjusted initial hospitalization rate, the age-sex-race-comorbidity-adjusted 1-year mortality rate after initial hospitalization, age-sex-race-comorbidity-adjusted procedure rates, 1-year all-cause rehospitalizations after initial pancreatic cancer hospitalization, and mean inflation-adjusted Medicare payment for initial hospitalization.

RESULTS:

A total of 130,728 patients had ≥ 1 hospitalizations for pancreatic cancer and were identified from 56,642,071 beneficiaries during the study period. The age-sex-race-adjusted rate of initial hospitalization for pancreatic cancer was 50 per 100,000 person-years in 2010, representing a 0.5% annual increase since 2000 (95% confidence interval [95% CI], 0.3%-0.7%). In the same period, the age-sex-race-comorbidity-adjusted 1-year mortality rate decreased by 4.4% (95% CI, 3.9%-4.9%), and the age-sex-race-comorbidity-adjusted surgical resection rate increased by 6.9% (95% CI, 6.4%-7.5%). The mean inflation-adjusted Medicare payment for the initial hospitalization decreased, from $14,118 in 2000 to $13,318 in 2010, and the number of 1-year all-cause rehospitalizations after the initial hospitalization increased from 0.75 per patient in 2000 to 0.82 per patient in 2009 (all P < .001).

CONCLUSIONS:

For Medicare fee-for-service beneficiaries, initial pancreatic cancer hospitalization, surgical resection, and rehospitalization rates increased, but 1-year mortality rates declined over the last decade.

KEYWORDS:

Medicare; hospitalization; mortality; outcomes; pancreatic cancer; trends

PMID:
24382787
PMCID:
PMC4019988
DOI:
10.1002/cncr.28537
[Indexed for MEDLINE]
Free PMC Article

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