Healthcare utilization and spending by children with cancer on Medicaid

Emily L. Mueller, Matt Hall, Jay G. Berry, Aaron Carroll, Michelle L. Macy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Children with cancer are a unique patient population with high resource, complex healthcare needs. Understanding their healthcare utilization could highlight areas for care optimization. Procedure: We performed a retrospective, cross-sectional analysis of the 2014 Truven Marketscan Medicaid Database to explore clinical attributes, utilization, and spending among children with cancer who were Medicaid enrollees. Eligible patients included children (ages 0-18 years) with cancer (Clinical Risk Group 8). Healthcare utilization and spending (per member per month, PMPM) were assessed overall and across specific healthcare services. Results: Children with cancer (n = 5,405) represent less than 1% of the 1,516,457 children with medical complexity in the dataset. Children with cancer had high services use: laboratory/radiographic testing (93.0%), outpatient specialty care (83.4%), outpatient therapy/treatment (53.4%), emergency department (43.7%), hospitalization (31.5%), home healthcare (9.5%). PMPM spending for children with cancer was $3,706 overall and $2,323 for hospital care. Conclusion: Children with cancer have high healthcare resource use and spending. Differences in geographic distribution of services for children with cancer and the trajectory of spending over the course of therapy are areas for future investigation aimed at lowering costs of care without compromising on health outcomes.

Original languageEnglish (US)
JournalPediatric Blood and Cancer
DOIs
StateAccepted/In press - 2017

Fingerprint

Medicaid
Delivery of Health Care
Neoplasms
Ambulatory Care
Hospital Emergency Service
Hospitalization
Outpatients
Therapeutics
Cross-Sectional Studies
Databases
Costs and Cost Analysis
Health

Keywords

  • Outcomes research
  • Pediatric oncology
  • Supportive care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Healthcare utilization and spending by children with cancer on Medicaid. / Mueller, Emily L.; Hall, Matt; Berry, Jay G.; Carroll, Aaron; Macy, Michelle L.

In: Pediatric Blood and Cancer, 2017.

Research output: Contribution to journalArticle

Mueller, Emily L. ; Hall, Matt ; Berry, Jay G. ; Carroll, Aaron ; Macy, Michelle L. / Healthcare utilization and spending by children with cancer on Medicaid. In: Pediatric Blood and Cancer. 2017.
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