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Using Comorbidity Indexes to Predict Costs for Head and Neck Cancer
Christopher S. Hollenbeak, PhD;
Brendan C. Stack Jr, MD;
Stephen M. Daley, PhD;
Jay F. Piccirillo, MD
Arch Otolaryngol Head Neck Surg. 2007;133(1):24-27.
Objective To determine whether the general Charlson Comorbidity Index (CCI) and the head and neck cancer–specific Washington University Head and Neck Cancer Comorbidity Index (WUHNCCI) were useful for predicting cost of treatment for elderly patients with head and neck cancer.
Design Retrospective, observational study.
Patients A total of 1780 Medicare patients with head and neck cancer, who were treated between 1984 and 1994, were analyzed using the Surveillance, Epidemiology, and End Results (SEER)-Medicare–linked database.
Main Outcome Measures Total Medicare payments were accumulated for each patient up to 1 and 5 years. Linear regression was used to estimate the impact of the comorbidity indexes on costs, controlling for demographics, site, stage, and treatment modality.
Results Neither the WUHNCCI nor the CCI was significantly associated with 1-year costs. However, the effect of the WUHNCCI on 5-year costs was statistically significant (P<.001). A 1-point increase in the WUHNCCI from 4 to 5 was associated with an increase in 5-year costs of $2105. A 1-point increase in the WUHNCCI from 9 to 10 was associated with an increase in 5-year costs of $2837.
Conclusion These results suggest that comorbidity indexes for head and neck cancer may be useful for prognostication of patient outcomes and predicting costs.
Author Affiliations: Departments of Surgery and Health Evaluation Sciences (Dr Hollenbeak) and Division of Otolaryngology–Head and Neck Surgery (Dr Stack), Penn State College of Medicine, Hershey, Pa; Department of Economics, George Mason University, Fairfax, Va (Dr Daley); and Department of Otolaryngology–Head and Neck Surgery and Clinical Outcomes Research Office, Washington University School of Medicine, St Louis, Mo (Dr Piccirillo).
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