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

Background: 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.

Methods: 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 (exp^β - 1).

Results: 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).

Conclusions: 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.

Keywords: Activities disability; Activities of daily living limitations; Instrumental activities of daily living limitations; Mental health status.