Premium
Rural‐Urban Differences in Costs of End‐of‐Life Care for the Last 6 Months of Life Among Patients with Breast, Lung, or Colorectal Cancer
Author(s) -
Crouch Elizabeth,
Eberth Jan M.,
Probst Janice C.,
Bennett Kevin,
Adams Swann A.
Publication year - 2018
Publication title -
the journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.439
H-Index - 57
eISSN - 1748-0361
pISSN - 0890-765X
DOI - 10.1111/jrh.12301
Subject(s) - medicine , colorectal cancer , breast cancer , lung cancer , rural area , health care , cancer , gerontology , demography , oncology , pathology , sociology , economics , economic growth
Purpose The purpose of this study was to examine rural‐urban differences in utilization and expenditures in the last 6 months of life for patients with breast, lung, or colorectal cancer. Methods The study used a 5% sample of the 2013 Medicare Research Identifiable Files to study utilization and expenditures for beneficiaries with breast, lung, or colorectal cancer during the last 6 months before death (n = 6,214). End of life expenditures were calculated as the sum of total Medicare expenditures for inpatient, outpatient, physician, home health, hospice, and skilled nursing facility costs during the last 6 months of life. Findings For each type of cancer, total Medicare expenditures in the last 6 months of life were lower for rural decedents compared to their urban counterparts. During the last 6 months of life, median Medicare expenditures were lower for rural decedents for breast cancer ($21,839 vs $25,698), lung cancer ($22,814 vs $27,635), and colorectal cancer ($24,156 vs $28,035; all differences significant at P < .05). In adjusted models, care for rural decedents was less costly than urban decedents for breast, lung, and colorectal cancer, respectively. Conclusions Our findings indicate that Medicare expenditures are lower for rural beneficiaries with each type of cancer than urban beneficiaries, even after adjusting for age, gender, race, dual eligibility, region, chronic conditions, and type of service utilization. The findings from this study can be useful for policymakers in developing programs and resource allocation decisions that impact rural beneficiaries.