Cancer Care Costs Dramatically Higher for Patients With Pre-Existing Psychiatric Diagnosis

10/04/17

Patients with cancer receiving radiation therapy who have a previous psychiatric diagnosis have 208% higher follow-up emergency department costs than patients without a pre-existing psychiatric diagnosis.

Those patients are also met with 193% higher follow-up hospital outpatient costs and 190% higher follow-up hospital inpatient costs.

Psychiatric health is a critical factor in comprehensive cancer care. However, limited research exist that quantify the impact of pre-existing psychiatric conditions on the cost of cancer care.

Mark Waddle, MD, radiation oncologist, Mayo Clinic (Jacksonville, FL), and colleagues conducted a study to examine costs for acute and follow-up for patients with cancer with and without psychiatric comorbidities. A total of 1275 patients were sampled from the Mayo Clinic from 2009 to 2014. Among this sample population, 9.9% had at least one pre-existing psychiatric diagnosis.

Researchers analyzed acute and follow-up costs from baseline to 6 months and from 6 to 24 months after the cancer diagnosis. Resulting data were categorized into clinic, emergency department, hospital inpatient, and hospital outpatient costs.

Findings were presented at the American Society for Radiation Oncology annual meeting (September 24-27, 2017; San Diego, CA).

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Results of the analysis showed that acute and long-term costs were higher in the patients with pre-existing psychiatric diagnoses, with the three largest difference in costs observed in follow-up emergency department costs (208% higher), follow-up hospital outpatient costs (193% higher), and follow-up hospital inpatient costs (190% higher).

Notable differences among the patients with vs without a pre-existing psychiatric diagnosis were a higher median number of comorbidities (five vs three) and more respiratory diagnoses (31% vs 17%). Age, race, sex, and treatment modalities were comparable among the groups.

“Our study suggests that interventions to improve anxiety, depression, alcohol, and drug dependence and other psychiatric comorbidities not only offers a chance to improve clinical outcomes, but also provides an opportunity to decrease costs not only for patients but for the US health care system as a whole,” Dr Waddle said in his presentation.—Zachary Bessette