Health care use and expenditures attributable to cancer: A population-based study

Background: As more people are living with cancer due to increases in cancer survival, it is important to understand cancer burden. Studies have examined cancer-related costs using data more than a decade ago. Objective: To update the economic burden and uniquely provide health care service use attributable to cancer using a nationally representative sample of the U.S. population. Methods: Data were obtained from the 2008-2015 Medical Expenditure Panel Survey (MEPS). Individuals with cancer were matched to those without cancer in terms of demographics and comorbidities based on a propensity score (PS). For outcomes of health care use, a (zero-inflated) negative binomial model was employed. To analyze the outcomes of health care spending, a generalized linear model with a log link function and gamma distributed errors (or a two-part model) was used. Results: Compared to the PS-matched noncancer controls, individuals with cancer received 1.05, 1.08, and 1.76 times more frequent annual emergency department (ED) visit care, hospitalization care, and hospital outpatient visit care, respectively. Additionally, people with cancer received prescriptions and office-based visit care about 5 times and 20 times more frequently. An average annual total health care spending among those with cancer was about $4100 higher. Average annual expenses on hospitalizations, office-based visits, hospital outpatient visits, and prescriptions among those with cancer were also about $1,400, $1,400, $700, and $300 higher. However, there was no significant difference in expenses on ED visit and out-of-pocket expenses on prescriptions between people with cancer and noncancer controls. Conclusions: Individuals with cancer used all types of health care services more frequently than noncancer controls. Accordingly, expenditures on various types of health care services among those with cancer were higher.