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Medicare Cancer Spending Has Little Effect on Survival

THURSDAY, March 14 (HealthDay News) -- Medicare spending for advanced cancer care has substantial regional variation, according to a study published online March 12 in the Journal of the National Cancer Institute.

Gabriel A. Brooks, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues used data from the Surveillance, Epidemiology and End Results (SEER)-Medicare linked set to identify 116,523 subjects (age 65 years and older) with advanced cancer.

The researchers identified 61,083 subjects with incident advanced-stage cancer (incident cohort) and 98,935 with death from cancer (decedent cohort), and 37 percent of subjects were included in both cohorts for analysis. Mean regional spending increased by 32 and 41 percent in the incident and decedent cohorts, respectively, when comparing quintile 1 to quintile 5 (incident cohort: $28,854 to $37,971; decedent cohort: $27,446 to $38,630). There was variance by cancer site and quintile as to the association between spending and survival, with hazard ratios ranging from 0.92 (95 percent confidence interval [CI], 0.82 to 1.04 for pancreas cancer quintile 5) to 1.24 (95 percent CI, 1.11 to 1.39 for breast cancer quintile 3). Differences in survival between quintile 1 and quintiles 2 through 5 were not statistically significant in most cases.

"There is substantial regional variation in Medicare spending for advanced cancer, yet no consistent association between mean regional spending and survival," the authors write.

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