Abstract
PurposeCancer diagnosis is known to affect the family; however, administrative claims data are not commonly used to evaluate the broader impact of cancer diagnosis. This study was designed to evaluate the feasibility of using claims data to explore the impact of cancer diagnosis on the caregiver.MethodsIBM Marketscan data were used to identify eligible cancer patients, who were required to have a second adult over the age of 18 (defined as “caregiver” for this study) covered by the same the healthcare policy. Eligible control pairs included any two adults in the same policy with no evidence of cancer; for each pair one adult was randomly assigned to be the “patient control” while their partner was assigned as “caregiver control”. Probabilistic stratified sampling was used select control pairs for analysis by matching the relative frequencies within sex and age group strata to those of patient/caregiver pairs. Eligible control pairs were probabilistically sampled without replacement until the stratum with at least 0.5 % relative frequency had been completely sampled. Caregiver and caregiver control healthcare resource utilization (HCRU), new diagnoses, and healthcare costs were compared during the 12-month post-diagnosis period. Subgroup analyses were conducted by cancer subtypes (breast, colorectal, lung, gastric, sarcoma) and by sex of the patient and caregiver.ResultsA total of 62,893 patient/caregiver pairs and 449,177 control pairs were included. Overall, caregivers used slightly fewer healthcare resources and expended less costs during the 12-month period after the cancer diagnosis than controls (physician visits; 85.8 % vs. 95.7 %; hospitalizations 5.4 % vs. 7.0 %; emergency room visits 15.7 % versus 16.2 %, all p ≤ 0.001). This finding was consistent in all subgroup analyses. New diagnoses were lower in the caregiver cohort, except for mental disorders, which were higher than controls (14.3 % vs. 9.9 %, p < 0.0001). Psychotherapeutic/antidepressant utilization occurred among 21.0 % of caregivers versus 17.2 % of caregiver controls during this period.ConclusionsIt is feasible to use administrative claims data to evaluate the impact of a cancer diagnosis on the caregiver to evaluate outcomes such as HCRU, diagnoses and costs. These findings raise hypotheses about deferment of health care and increased mental distress during the caregiving period.
Highlights
In the United States (U.S.), there are approximately 1,898,160 new cancer diagnoses and 608,570 cancer deaths expected in 2021 alone [1]
A total of 62,893 patient/caregiver pairs and 3,054,094 control pairs were eligible for inclusion in this study
This study examined the ability of administrative claims data to be used to examine the impact of a cancer diagnosis on caregivers
Summary
In the United States (U.S.), there are approximately 1,898,160 new cancer diagnoses and 608,570 cancer deaths expected in 2021 alone [1]. A cancer diagnosis affects the person receiving the diagnosis but has an impact on the entire family unit. The burden of a cancer diagnosis to the broader family, and particular to the adult partner or caregiver, is often underrecognized in retrospective observational research, largely due to challenges related to limited real-world data that may be used to quantify the broader impact of a cancer diagnosis. Caregiving is typically defined as informal support from informal family members whose time and efforts are not covered by insurance. These efforts may include increased financial responsibilities, driving to and from health care appointments, increased responsibilities in the home, such as cleaning and meal preparation, as well as ensuring medication and nutrition intake is maintained. Unlike home health or nursing support, the cost of caregiving is not a reimbursable expense, and individuals caring for a family member with cancer have been documented to suffer loss of employment, reduced productivity, and working extra hours and at lower paying jobs to accommodate the schedule needed to care for a loved one with cancer [2, 3]
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