PMID- 32351875
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220414
IS  - 2213-5383 (Print)
IS  - 2213-5383 (Electronic)
IS  - 2213-5383 (Linking)
VI  - 23
DP  - 2020 Mar
TI  - Estimating cost implications of potentially avoidable hospitalizations among 
      Oncology Care Model patients with prostate cancer.
LID - 100218 [pii]
LID - 10.1016/j.jcpo.2020.100218 [doi]
AB  - PURPOSE/OBJECTIVES: We sought to estimate the expected cost savings generated if 
      a set of potentially avoidable hospitalizations (PAHs) among oncology care model 
      (OCM) patients with prostate cancer were shifted to an acute care model in the 
      outpatient setting. METHODS: We previously identified a set of 28 PAHs among OCM 
      prostate cancer patients. Outpatient management costs for a characteristically 
      similar cohort of cancer patients were obtained from our institution's ambulatory 
      acute-care Oncology Care Unit (OCU). We excluded OCU visits resulting in 
      hospitalization, involving non-cancer diagnoses, and those missing 
      clinical/financial information. Exact-matching based on the strata of age, 
      categorically-defined presenting complaint, and systemic disease was used to 
      match PAHs to OCU acute care visits. PAH costs obtained from OCM data were 
      compared to costs from matched OCU visits. RESULTS: We identified 130 acute care 
      OCU visits, of which 47 met inclusion criteria. Twenty-four PAHs (89%) matched to 
      26 of these OCU visits. PAHs accounted for 5.8% of OCM expenditures during our 
      study period. The mean inpatient cost among matched PAHs was $15,885 compared to 
      $6,227 for matched OCU visits. Boot strapping within each match stratum produced 
      a mean estimated cost savings of $12,151 (95% CI $10,488 to $13,814) per PAH. We 
      estimate this per event savings to yield a 4.4% (95% CI 3.8% to 5.0%) an overall 
      spending decrement for OCM prostate cancer episodes. CONCLUSIONS: PAHs contribute 
      meaningfully to costs of care in oncology. Investment in specialized ambulatory 
      acute care services for oncology patients could lead to substantial cost savings.
FAU - Smith, William H
AU  - Smith WH
AD  - Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New 
      York, NY, USA.
FAU - Parikh, Anish B
AU  - Parikh AB
AD  - Division of Medical Oncology, The Ohio State University College of Medicine, 
      Columbus, OH, USA.
FAU - Li, Lihua
AU  - Li L
AD  - Institute of Healthcare Delivery Science, Icahn School of Medicine at Mount 
      Sinai, New York, NY, USA.
FAU - Sanderson, Mark
AU  - Sanderson M
AD  - Department of Health System Design and Global Health, Icahn School of Medicine at 
      Mount Sinai, New York, NY, USA.
FAU - Liu, Mark
AU  - Liu M
AD  - Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 
      USA.
FAU - Mazumdar, Madhu
AU  - Mazumdar M
AD  - Institute of Healthcare Delivery Science, Icahn School of Medicine at Mount 
      Sinai, New York, NY, USA.
FAU - Isola, Luis M
AU  - Isola LM
AD  - Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 
      USA.
FAU - Dharmarajan, Kavita V
AU  - Dharmarajan KV
AD  - Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New 
      York, NY, USA.
AD  - Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of 
      Medicine at Mount Sinai, New York, NY, USA.
LA  - eng
GR  - P30 AG028741/AG/NIA NIH HHS/United States
GR  - P30 CA196521/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20200114
PL  - England
TA  - J Cancer Policy
JT  - Journal of cancer policy
JID - 101639933
PMC - PMC7189771
MID - NIHMS1551682
OTO - NOTNLM
OT  - Acute oncology care
OT  - Oncology Care Model
OT  - Potentially avoidable hospitalizations
OT  - Prostate cancer outcomes
OT  - Value-based healthcare
COIS- Conflicts of Interest Statement Mark Liu has received honoraria from 
      Bristol-Myers Squib. The remaining authors of this study certify that they have 
      no affiliation or involvement in any organization or entity with any financial 
      interest or non-financial interest in the subject matter discussed in this 
      manuscript.
EDAT- 2020/05/01 06:00
MHDA- 2020/05/01 06:01
PMCR- 2021/03/01
CRDT- 2020/05/01 06:00
PHST- 2020/05/01 06:00 [entrez]
PHST- 2020/05/01 06:00 [pubmed]
PHST- 2020/05/01 06:01 [medline]
PHST- 2021/03/01 00:00 [pmc-release]
AID - 100218 [pii]
AID - 10.1016/j.jcpo.2020.100218 [doi]
PST - ppublish
SO  - J Cancer Policy. 2020 Mar;23:100218. doi: 10.1016/j.jcpo.2020.100218. Epub 2020 
      Jan 14.