Economic disparities in treatment costs among ambulatory medicaid cancer patients

C. Daniel Mullins, Stephen E. Snyder, Junling Wang, Jesse L. Cooke, Claudia Baquet

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Cancer is the second leading cause of death in the United States and a major contributor to healthcare expenditure. There are few studies examining disparities in treatment costs. Studies that do exist are dominated by the cost of hospital care. Methods: Utilizing Maryland Medicaid administrative claims data, a retrospective cohort, design was employed to examine disparities in ambulatory treatment costs of breast, colorectal and prostate cancer treatment by region, race and gender. We report mean and median results by each demographic category and test for the statistical significance of each. Lorenz curves are plotted and Gini coefficients calculated for each type of cancer. Results: We do not find a consistent trend in ambulatory costs across the three cancers by traditional demographic variables. Lorenz curves indicate highly unequal distributions of costs. Gini coefficients are 0.687 for breast cancer, 0.757 for colorectal cancer and 0.774 for prostate cancer. Conclusion: Significant variation in nonhospital-based expenditures exists for breast, colorectal and prostate cancers in a population of homogeneous socioeconomic status and uniform insurance entitlement. Observed individual-level disparities are not consistent across cancers by region, race or gender, but the majority of this low-income population receives very little ambulatory care.

Original languageEnglish (US)
Pages (from-to)1565-1574
Number of pages10
JournalJournal of the National Medical Association
Volume96
Issue number12
StatePublished - Dec 1 2004

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Medicaid
Health Care Costs
Prostatic Neoplasms
Economics
Colorectal Neoplasms
Breast Neoplasms
Health Expenditures
Neoplasms
Demography
Costs and Cost Analysis
Second Primary Neoplasms
Hospital Costs
Poverty
Ambulatory Care
Insurance
Social Class
Cause of Death
Delivery of Health Care
Population
Therapeutics

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Economic disparities in treatment costs among ambulatory medicaid cancer patients. / Mullins, C. Daniel; Snyder, Stephen E.; Wang, Junling; Cooke, Jesse L.; Baquet, Claudia.

In: Journal of the National Medical Association, Vol. 96, No. 12, 01.12.2004, p. 1565-1574.

Research output: Contribution to journalArticle

Mullins, CD, Snyder, SE, Wang, J, Cooke, JL & Baquet, C 2004, 'Economic disparities in treatment costs among ambulatory medicaid cancer patients', Journal of the National Medical Association, vol. 96, no. 12, pp. 1565-1574.
Mullins, C. Daniel ; Snyder, Stephen E. ; Wang, Junling ; Cooke, Jesse L. ; Baquet, Claudia. / Economic disparities in treatment costs among ambulatory medicaid cancer patients. In: Journal of the National Medical Association. 2004 ; Vol. 96, No. 12. pp. 1565-1574.
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