Costs from a healthcare and societal perspective among cancer patients after total laryngectomy: are they related to patient activation?

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Abstract

Purpose: The aim of this study is to investigate the associations between patient activation and total costs in cancer patients treated with total laryngectomy (TL). Methods: All members of the Dutch Patients’ Association for Laryngectomees were asked to participate in this cross-sectional study. TL patients who wanted to participate were asked to complete a survey. Costs were measured using the medical consumption and productivity cost questionnaire and patient activation using the Patient Activation Measure (PAM). Sociodemographic and clinical characteristics were self-reported, and health status measured using the EQ-5D. The difference in total costs from a healthcare and societal perspective among four groups with different PAM levels were compared using (multiple) regression analyses (5000 bootstrap replications). Results: In total, 248 TL patients participated. Patients with a higher (better) PAM (levels 2, 3, and 4) had a probability of 70, 80, and 93% that total costs from a healthcare perspective were lower than in patients with the lowest PAM level (difference €−375 to €−936). From a societal perspective, this was 73, 87, and 82% (difference €−468 to €−719). After adjustment for time since TL, education, and sex, the probability that total costs were lower in patients with a higher PAM level compared to patients with the lowest PAM level changed to 62–91% (healthcare) and 63–92% (societal). After additional adjustment for health status, the probability to be less costly changed to 35–71% (healthcare) and 31–48% (societal). Conclusions: A better patient activation is likely to be associated with lower total costs from a healthcare and societal perspective.

Original languageEnglish
Pages (from-to)1221-1231
Number of pages11
JournalSupportive Care in Cancer
Volume26
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018

Cite this

@article{13b12ba7a5264ccc899dcaf1b7e62daa,
title = "Costs from a healthcare and societal perspective among cancer patients after total laryngectomy: are they related to patient activation?",
abstract = "Purpose: The aim of this study is to investigate the associations between patient activation and total costs in cancer patients treated with total laryngectomy (TL). Methods: All members of the Dutch Patients’ Association for Laryngectomees were asked to participate in this cross-sectional study. TL patients who wanted to participate were asked to complete a survey. Costs were measured using the medical consumption and productivity cost questionnaire and patient activation using the Patient Activation Measure (PAM). Sociodemographic and clinical characteristics were self-reported, and health status measured using the EQ-5D. The difference in total costs from a healthcare and societal perspective among four groups with different PAM levels were compared using (multiple) regression analyses (5000 bootstrap replications). Results: In total, 248 TL patients participated. Patients with a higher (better) PAM (levels 2, 3, and 4) had a probability of 70, 80, and 93{\%} that total costs from a healthcare perspective were lower than in patients with the lowest PAM level (difference €−375 to €−936). From a societal perspective, this was 73, 87, and 82{\%} (difference €−468 to €−719). After adjustment for time since TL, education, and sex, the probability that total costs were lower in patients with a higher PAM level compared to patients with the lowest PAM level changed to 62–91{\%} (healthcare) and 63–92{\%} (societal). After additional adjustment for health status, the probability to be less costly changed to 35–71{\%} (healthcare) and 31–48{\%} (societal). Conclusions: A better patient activation is likely to be associated with lower total costs from a healthcare and societal perspective.",
keywords = "Head and neck cancer, Health service utilization, Laryngeal cancer, Patient activation, Self-management, Total laryngectomy",
author = "Femke Jansen and Coup{\'e}, {Veerle M.H.} and Eerenstein, {Simone E.J.} and Leemans, {C. R.} and {Verdonck-de Leeuw}, {Irma M.}",
year = "2018",
month = "4",
day = "1",
doi = "10.1007/s00520-017-3945-8",
language = "English",
volume = "26",
pages = "1221--1231",
journal = "Supportive Care in Cancer",
issn = "0941-4355",
publisher = "Springer Verlag",
number = "4",

}

TY - JOUR

T1 - Costs from a healthcare and societal perspective among cancer patients after total laryngectomy

T2 - are they related to patient activation?

AU - Jansen, Femke

AU - Coupé, Veerle M.H.

AU - Eerenstein, Simone E.J.

AU - Leemans, C. R.

AU - Verdonck-de Leeuw, Irma M.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Purpose: The aim of this study is to investigate the associations between patient activation and total costs in cancer patients treated with total laryngectomy (TL). Methods: All members of the Dutch Patients’ Association for Laryngectomees were asked to participate in this cross-sectional study. TL patients who wanted to participate were asked to complete a survey. Costs were measured using the medical consumption and productivity cost questionnaire and patient activation using the Patient Activation Measure (PAM). Sociodemographic and clinical characteristics were self-reported, and health status measured using the EQ-5D. The difference in total costs from a healthcare and societal perspective among four groups with different PAM levels were compared using (multiple) regression analyses (5000 bootstrap replications). Results: In total, 248 TL patients participated. Patients with a higher (better) PAM (levels 2, 3, and 4) had a probability of 70, 80, and 93% that total costs from a healthcare perspective were lower than in patients with the lowest PAM level (difference €−375 to €−936). From a societal perspective, this was 73, 87, and 82% (difference €−468 to €−719). After adjustment for time since TL, education, and sex, the probability that total costs were lower in patients with a higher PAM level compared to patients with the lowest PAM level changed to 62–91% (healthcare) and 63–92% (societal). After additional adjustment for health status, the probability to be less costly changed to 35–71% (healthcare) and 31–48% (societal). Conclusions: A better patient activation is likely to be associated with lower total costs from a healthcare and societal perspective.

AB - Purpose: The aim of this study is to investigate the associations between patient activation and total costs in cancer patients treated with total laryngectomy (TL). Methods: All members of the Dutch Patients’ Association for Laryngectomees were asked to participate in this cross-sectional study. TL patients who wanted to participate were asked to complete a survey. Costs were measured using the medical consumption and productivity cost questionnaire and patient activation using the Patient Activation Measure (PAM). Sociodemographic and clinical characteristics were self-reported, and health status measured using the EQ-5D. The difference in total costs from a healthcare and societal perspective among four groups with different PAM levels were compared using (multiple) regression analyses (5000 bootstrap replications). Results: In total, 248 TL patients participated. Patients with a higher (better) PAM (levels 2, 3, and 4) had a probability of 70, 80, and 93% that total costs from a healthcare perspective were lower than in patients with the lowest PAM level (difference €−375 to €−936). From a societal perspective, this was 73, 87, and 82% (difference €−468 to €−719). After adjustment for time since TL, education, and sex, the probability that total costs were lower in patients with a higher PAM level compared to patients with the lowest PAM level changed to 62–91% (healthcare) and 63–92% (societal). After additional adjustment for health status, the probability to be less costly changed to 35–71% (healthcare) and 31–48% (societal). Conclusions: A better patient activation is likely to be associated with lower total costs from a healthcare and societal perspective.

KW - Head and neck cancer

KW - Health service utilization

KW - Laryngeal cancer

KW - Patient activation

KW - Self-management

KW - Total laryngectomy

UR - http://www.scopus.com/inward/record.url?scp=85032901164&partnerID=8YFLogxK

U2 - 10.1007/s00520-017-3945-8

DO - 10.1007/s00520-017-3945-8

M3 - Article

VL - 26

SP - 1221

EP - 1231

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

IS - 4

ER -