TY - JOUR
T1 - Costs from a healthcare and societal perspective among cancer patients after total laryngectomy: are they related to patient activation?
T2 - are they related to patient activation?
AU - Jansen, Femke
AU - Coupé, Veerle M. H.
AU - Eerenstein, Simone E. J.
AU - Leemans, C. René
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 - Journal Article
KW - Laryngeal cancer
KW - Patient activation
KW - Self-management
KW - Total laryngectomy
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85032901164&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29098402
UR - http://www.scopus.com/inward/record.url?scp=85032901164&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85032901164&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00520-017-3945-8
DO - https://doi.org/10.1007/s00520-017-3945-8
M3 - Article
C2 - 29098402
SN - 0941-4355
VL - 26
SP - 1221
EP - 1231
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 4
ER -