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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 10 of 10 Research Studies DisplayedHerb JN, Ollila DW, Stitzenberg KB
Use and costs of sentinel lymph node biopsy in non-ulcerated T1b melanoma: analysis of a population-based registry.
This study looked at the utility of sentinel lymph node biopsy (SLNB) for non-ulcerated T1b melanoma. The aim of the study was to estimate SLNB use, positivity, prevalence, and procedural costs in patients with non-ulcerated T1b melanoma using a population-based registry. Patients with clinically node-negative, non-ulcerated T1b melanoma were identified in the SEER database from 2010 to 2016. Among 7245 included patients, 53% underwent SLNB of which 156 (4.1%) had a positive SLNB. Higher odds of positivity were associated with younger age, >1 mitosis per mm2, female sex, and truncal tumor location. Estimated SLNB costs to identify one patient with Stage II disease was $71,700. Out-of-pocket expenses for a Medicare patient was estimated to be $652 for a wide local excision (WLE) and SLNB and $79 for WLE alone.
AHRQ-funded; HS000032.
Citation: Herb JN, Ollila DW, Stitzenberg KB .
Use and costs of sentinel lymph node biopsy in non-ulcerated T1b melanoma: analysis of a population-based registry.
Ann Surg Oncol 2021 Jul;28(7):3470-78. doi: 10.1245/s10434-021-09998-6..
Keywords: Cancer: Skin Cancer, Cancer, Surgery, Healthcare Costs, Skin Conditions
Medbery RL, Fernandez FG, Kosinski AS
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Researchers sought to identify underlying case mix factors that contribute to variability of 90-day costs of lobectomy for early-stage lung cancer. Using the Society of Thoracic Surgeons General Thoracic Surgery Database, they found that lobectomy is associated with substantial variability of episode-of-care costs. Variability is driven by patient demographic and clinical factors, hospital characteristics, and the occurrence and severity of complications.
AHRQ-funded; R01 HS022279.
Citation: Medbery RL, Fernandez FG, Kosinski AS .
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Ann Thorac Surg 2021 Jun;111(6):1781-90. doi: 10.1016/j.athoracsur.2020.08.073..
Keywords: Cancer: Lung Cancer, Cancer, Healthcare Costs, Surgery, Elderly, Medicare
Cowper PA, Feng L, Kosinski AS
Initial and longitudinal cost of surgical resection for lung cancer.
This study looked at the 4-year longitudinal cost of surgical resection of non-small cell lung cancer (NSCLC). The study describes initial and 4-year resource use and cost for NSCLC patients aged 65 years of age or older who were treated surgically from 2008 to 2013. Clinical data for NSCLC resections from The Society of Thoracic Surgery Database linked to Medicare claims, resource use and cost of preoperative staging, surgery, and subsequent care through 4 years were examined. Outcomes were stratified by pathologic stage and surgical approach for stage I lobectomy patients. In the first 90 days costs ranged from $12,430 for stage I to $26,350 for stage IV. Cumulative costs ranged from $131,032 for stage I to $205,368 for stage IV. For the stage I lobectomy cohort, patients who had minimally invasive procedures had lower 4-year costs than thoracotomy patients ($120,346 versus $136,250).
AHRQ-funded; R01 HS022279.
Citation: Cowper PA, Feng L, Kosinski AS .
Initial and longitudinal cost of surgical resection for lung cancer.
Ann Thorac Surg 2021 Jun;111(6):1827-33. doi: 10.1016/j.athoracsur.2020.07.048..
Keywords: Cancer: Lung Cancer, Cancer, Surgery, Healthcare Costs
Diaz A, Chhabra KR, Dimick JB
Variations in surgical spending within hospital systems for complex cancer surgery.
Researchers sought to measure variations in episode spending within and across hospital systems among Medicare beneficiaries undergoing complex cancer surgery. They found wide variations in surgical episode spending both within and across hospital systems. They recommended that system leaders seek better understanding of variations in practices among their hospitals to standardize care and reduce variations in outcomes, use, and costs.
AHRQ-funded; HS024763.
Citation: Diaz A, Chhabra KR, Dimick JB .
Variations in surgical spending within hospital systems for complex cancer surgery.
Cancer 2021 Feb 15;127(4):586-97. doi: 10.1002/cncr.33299..
Keywords: Surgery, Cancer, Healthcare Costs, Health Systems, Hospitals
Bateni SB, Gingrich AA, Jeon SY
Clinical outcomes and costs following unplanned excisions of soft tissue sarcomas in the elderly.
This study’s goal was to analyze the costs and outcomes of planned vs. unplanned soft tissue sarcoma (STS) excisions in the Medicare population. The authors analyzed 3913 surgical patients with STS >/=66 y old from 1992 to 2011 using the Surveillance, Epidemiology, and End Results-Medicare (SEER-Medicare) datafiles. Planned excision rates were classified from preoperative MRI or biopsy records. There was no difference in survival rates between planned vs. unplanned excisions. Planned excisions costs were higher than unplanned excision with the first resection contributing to the majority of costs.
AHRQ-funded; HS022236.
Citation: Bateni SB, Gingrich AA, Jeon SY .
Clinical outcomes and costs following unplanned excisions of soft tissue sarcomas in the elderly.
J Surg Res 2019 Jul;239:125-35. doi: 10.1016/j.jss.2019.01.055..
Keywords: Healthcare Costs, Cancer, Elderly, Surgery, Outcomes, Patient-Centered Outcomes Research
Shubeck SP, Thumma JR, Dimick JB
Hospital quality, patient risk, and Medicare expenditures for cancer surgery.
The authors evaluated the potential interactive effect of hospital quality and patient risk on expenditures for cancer resections. They found that the total episode expenditures for cancer resections were lower when care was delivered at low-complication, high-quality hospitals. Expenditure differences were particularly large for high-risk patients, suggesting that the selective referral of high-risk patients to high-quality centers may be an effective strategy for optimizing value in cancer surgery.
AHRQ-funded; HS024763.
Citation: Shubeck SP, Thumma JR, Dimick JB .
Hospital quality, patient risk, and Medicare expenditures for cancer surgery.
Cancer 2018 Feb 15;124(4):826-32. doi: 10.1002/cncr.31120.
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Keywords: Cancer, Healthcare Costs, Quality of Care, Hospitals, Surgery
Balentine CJ, Vanness DJ, Schneider DF
Cost-effectiveness of lobectomy versus genetic testing (Afirma(R)) for indeterminate thyroid nodules: considering the costs of surveillance.
This study evaluated whether diagnostic thyroidectomy for indeterminate thyroid nodules would be more cost-effective than genetic testing after including the costs of long-term surveillance. Its base case estimate suggests that diagnostic lobectomy dominates genetic testing as a strategy for ruling out malignancy of indeterminate thyroid nodules.
AHRQ-funded; HS023009.
Citation: Balentine CJ, Vanness DJ, Schneider DF .
Cost-effectiveness of lobectomy versus genetic testing (Afirma(R)) for indeterminate thyroid nodules: considering the costs of surveillance.
Surgery 2018 Jan;163(1):88-96. doi: 10.1016/j.surg.2017.10.004.
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Keywords: Cancer, Shared Decision Making, Diagnostic Safety and Quality, Genetics, Healthcare Costs, Screening, Surgery
Shen C, Tina Shih YC
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
The authors studied the impact of the fast diffusion of robotic surgical systems on the overall treatment pattern of localized prostate cancer. They found that the density of robotic systems at state-level had a significantly positive impact on the rate of surgery and a significantly negative impact on the rate of radiation therapy. They concluded that part of the increase in the rate of surgery was driven by substitution across treatment types with a large proportion originating from the younger population.
AHRQ-funded; HS018535; HS020263.
Citation: Shen C, Tina Shih YC .
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
Soc Sci Med 2016 Feb;151:110-20. doi: 10.1016/j.socscimed.2016.01.016.
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Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Healthcare Costs, Treatments
Vemana G, Vetter J, Chen L
Sources of variation in follow-up expenditure after radical cystectomy.
Follow-up care after radical cystectomy is poorly defined, with extensive variation in practice patterns. The researchers sought to determine sources of these variations in care as well as examine the economic effect of standardization of care on guideline-recommended care. The most variation in expenditure on follow-up care was at the patient level, largely based on node positivity, chemotherapy status, and final cancer stage.
AHRQ-funded; HS019455.
Citation: Vemana G, Vetter J, Chen L .
Sources of variation in follow-up expenditure after radical cystectomy.
Urol Oncol 2015 Jun;33(6):267.e31-7. doi: 10.1016/j.urolonc.2015.03.009..
Keywords: Cancer, Surgery, Healthcare Costs, Elderly
Zanocco K, Elaraj D, Sturgeon C
Routine prophylactic central neck dissection for low-risk papillary thyroid cancer: a cost-effectiveness analysis.
The researchers hypothesized that routine prophylactic central neck dissection (pCND) is not cost-effective in low-risk papillary thyroid cancer (PTC).Using a Markov transition-state model, they found that pCND cost $10,315 and produced an effectiveness of 23.785 quality-adjusted life years. They concluded that routine pCND for low-risk PTC is not cost-effective unless the recurrence rate is greater than 10.3 percent.
AHRQ-funded; HS000078.
Citation: Zanocco K, Elaraj D, Sturgeon C .
Routine prophylactic central neck dissection for low-risk papillary thyroid cancer: a cost-effectiveness analysis.
Surgery 2013 Dec;154(6):1148-55; discussion 54-5..
Keywords: Cancer, Surgery, Prevention, Healthcare Costs, Quality of Life