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J Thorac Cardiovasc Surg 1996;112:356-363
© 1996 Mosby, Inc.

GENERAL THORACIC SURGERY

COST OF PATIENT FOLLOW-UP AFTER POTENTIALLY CURATIVE LUNG CANCER TREATMENT

Supported in part by a Veterans Administration Health Services Research and Development Investigator Initiated Research grant No. 91-074.2.

Received for publication Sept. 12, 1995 Revisions requested Oct. 24, 1995; revisions received Nov. 16, 1995 Accepted for publication Nov. 21, 1995. Address for reprints: Katherine S. Virgo, PhD, Health Services Research, Department of Surgery, St. Louis University Health Sciences Center, 3635 Vista Ave., P.O. Box 15250, St. Louis, MO 63110-0250.

Abstract

The two objectives of this study were to determine the range of recommended follow-up strategies for patients with lung cancer treated with curative intent and to estimate the cost of such follow-up. Ten articles delineating eight specific follow-up strategies were identified from a Medline search of the literature for 1980 through 1995. An economic analysis was done of the costs associated with the identified strategies. Charge data obtained from the Part B Medicare Annual Data file and the Hospital Outpatient Bill file were used as a proxy for cost. Follow-up intensity varied widely across strategies for 5 years of posttreatment follow-up. Medicare-allowed charges for 5-year follow-up ranged from a low of $946 to a high of $5645. When Medicare-allowed charges were converted to a proxy for actual charges by a conversion ratio of 1.62, the range was $1533 to $9145, a fivefold difference in charges. There was no indication that more intensive, higher-cost strategies increased survival or quality of life. The published literature, including textbooks, holds few answers in this area. (J THORAC CARDIOVASC SURG 1996;112:356-63)

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