Estimates and predictors of health care costs of esophageal adenocarcinoma: a population-based cohort study

Thein, Hla-Hla; Jembere, Nathaniel; Thavorn, Kednapa; Chan, Kelvin K. W.; Coyte, Peter C.; de Oliveira, Claire; Hur, Chin; Earle, Craig C.

doi:10.1186/s12885-018-4620-2

BMC Cancer

Table 5 Predictors of total net costs of care in individuals with a diagnosis of esophageal adenocarcinoma according to phase of care, 2003–2011: Univariate generalized estimation equations

From: Estimates and predictors of health care costs of esophageal adenocarcinoma: a population-based cohort study

Variable	Initial Phase			Continuing Care Phase			Terminal Phase
	Estimate	95% CI	P-value	Estimate	95% CI	P-value	Estimate	95% CI	P-value
	N = 4178			N = 3472			N = 5972
Age group at index date (years)^*
< 50	Reference			Reference			Reference
50–54	0.112	− 0.121–0.343	0.343	0.303	0.087–0.518	0.006	−0.038	− 0.272–0.194	0.749
55–59	− 0.011	− 0.236–0.211	0.921	0.104	− 0.106–0.311	0.328	− 0.106	− 0.331–0.117	0.355
60–64	0.022	− 0.191–0.230	0.838	0.340	0.141–0.534	0.001	0.008	− 0.205–0.216	0.942
65–69	0.162	− 0.053–0.374	0.135	0.549	0.349–0.746	< 0.001	0.006	−0.210–0.217	0.960
70–74	0.156	−0.063–0.372	0.158	0.751	0.548–0.951	< 0.001	0.246	0.030–0.458	0.024
75–79	− 0.041	− 0.264–0.179	0.716	0.786	0.578–0.990	< 0.001	0.220	0.001–0.435	0.047
80–84	0.184	− 0.059–0.426	0.137	0.854	0.624–1.085	< 0.001	0.238	0.004–0.470	0.045
≥ 85	0.273	0.003–0.549	0.049	0.992	0.730–1.260	< 0.001	0.328	0.076–0.581	0.011
Gender
Male	Reference			Reference			Reference
Female	0.006	−0.125–0.141	0.928	0.084	− 0.041–0.213	0.193	0.041	− 0.087–0.172	0.539
Residence
Urban	Reference			Reference			Reference
Rural	−0.006	− 0.133–0.124	0.924	− 0.073	− 0.194–0.052	0.246	0.001	− 0.124–0.129	0.987
Birth country
Outside of Canada	Reference			Reference			Reference
Canada	0.006	− 0.130–0.139	0.932	0.067	−0.173–0.298	0.574	0.020	−0.073–0.112	0.668
Income quintile^†
Q1 (lowest)	− 0.040	− 0.196–0.116	0.619	0.017	− 0.131–0.164	0.822	0.141	− 0.013–0.295	0.072
Q2	−0.077	− 0.234–0.079	0.331	− 0.023	− 0.172–0.125	0.758	0.213	0.059–0.366	0.007
Q3	−0.091	− 0.250–0.068	0.260	− 0.067	− 0.217–0.084	0.383	0.247	0.090–0.404	0.002
Q4	0.043	−0.111–0.196	0.587	0.151	0.005–0.296	0.042	0.117	−0.037–0.27	0.135
Q5 (highest)	Reference			Reference			Reference
Ontario health region^**
Central	Reference			Reference			Reference
Erie St. Clair	−0.073	−0.353–0.212	0.610	0.061	−0.200–0.327	0.649	0.052	−0.227–0.335	0.716
South West	−0.071	− 0.316–0.174	0.571	− 0.326	− 0.557– − 0.097	0.005	0.173	− 0.069–0.412	0.159
Waterloo Wellington	0.085	− 0.186–0.360	0.539	−0.094	− 0.351–0.166	0.475	0.214	− 0.055–0.486	0.121
Hamilton Niagara Haldimand Brant	0.048	−0.174–0.265	0.666	0.011	−0.198–0.216	0.917	0.062	−0.160–0.279	0.579
Central West	0.383	0.068–0.712	0.020	0.326	0.031–0.633	0.033	0.144	−0.175–0.476	0.386
Mississauga	0.018	−0.266–0.309	0.901	−0.090	− 0.358–0.184	0.513	0.235	− 0.048–0.523	0.106
Toronto Central	0.046	−0.214–0.308	0.729	0.328	0.082–0.576	0.009	0.291	0.032–0.551	0.028
Central East	−0.035	− 0.267–0.194	0.767	−0.060	− 0.278–0.155	0.586	0.053	− 0.179–0.281	0.651
South East	0.051	−0.206–0.309	0.696	0.049	−0.193–0.292	0.692	−0.085	− 0.342–0.172	0.515
Champlain	0.047	−0.182–0.272	0.686	0.043	−0.173–0.256	0.691	0.032	−0.199–0.260	0.782
North Simcoe Muskoka	−0.025	− 0.304–0.259	0.861	− 0.014	− 0.276–0.254	0.920	0.026	− 0.252–0.309	0.855
North East	− 0.046	− 0.308–0.218	0.732	− 0.090	− 0.337–0.158	0.474	0.245	− 0.017–0.507	0.067
North West	0.010	− 0.338–0.379	0.957	− 0.026	− 0.359–0.329	0.884	0.164	− 0.178–0.525	0.359
ADGs^‡
0	Reference			Reference			Reference
1–3	0.201	−1.302–1.236	0.747	0.642	−0.719–1.609	0.263	−0.341	−1.393–0.470	0.463
4–7	0.083	−1.407–1.087	0.893	0.801	−0.547–1.738	0.155	−0.564	− 1.595–0.212	0.212
8–10	0.211	− 1.277–1.213	0.729	1.045	− 0.301–1.980	0.063	− 0.507	− 1.537–0.265	0.259
11+	0.334	− 1.153–1.334	0.584	1.504	0.159–2.436	0.008	−0.472	−1.501–0.297	0.293
Stage at EAC diagnosis^§
Stage 0-I	Reference			Reference			Reference
Stage II	0.191	0.006–0.371	0.040	0.054	− 0.164–0.266	0.621	0.229	0.014–0.435	0.033
Stage III	0.396	0.210–0.577	< 0.001	0.067	− 0.157–0.284	0.551	0.422	0.209–0.627	< 0.001
Stage IV	0.201	0.010–0.388	0.037	−0.028	− 0.277–0.219	0.823	0.814	0.613–1.006	< 0.001
EAC treatment^¶
No treatment	Reference			Reference			Reference
Surgery alone	0.231	0.106–0.356	< 0.001	0.673	0.512–0.832	< 0.001	−0.375	− 0.485– − 0.263	< 0.001
Chemotherapy alone	0.327	0.170–0.489	< 0.001	0.389	0.189–0.592	< 0.001	− 0.218	− 0.349– − 0.084	0.001
Radiotherapy alone	0.493	0.352–0.636	< 0.001	0.435	0.251–0.619	< 0.001	−0.328	− 0.450– − 0.203	< 0.001
Surgery + chemotherapy	0.312	0.108–0.524	0.003	0.682	0.447–0.925	< 0.001	− 0.717	− 0.921– − 0.500	< 0.001
Surgery + radiotherapy	0.304	− 0.700–1.799	0.620	− 0.300	−1.193–0.953	0.572	0.173	− 0.610–1.228	0.705
Chemotherapy + radiotherapy	0.344	0.126–0.574	0.003	0.653	0.396–0.923	< 0.001	−0.387	− 0.598– − 0.162	0.001
Surgery + chemotherapy + radiotherapy	0.488	− 0.098–1.210	0.139	− 0.154	−1.047–1.098	0.771	−1.011	− 1.743– − 0.046	0.017
Year of EAC diagnosis^€
2003	Reference			Reference			Reference
2004	0.015	−0.208–0.238	0.896	0.010	−0.193–0.213	0.922	−0.131	− 0.352–0.090	0.245
2005	−0.056	− 0.285–0.174	0.633	− 0.158	− 0.365–0.049	0.134	0.064	− 0.159–0.287	0.573
2006	0.401	0.183–0.619	< 0.001	0.073	− 0.129–0.273	0.478	0.033	− 0.183–0.248	0.763
2007	0.292	0.069–0.514	0.010	−0.053	− 0.257–0.150	0.607	0.175	− 0.044–0.394	0.117
2008	0.367	0.151–0.581	0.001	−0.181	− 0.377–0.014	0.069	0.351	0.139–0.561	0.001
2009	0.527	0.316–0.735	< 0.001	−0.274	− 0.467– − 0.084	0.005	0.327	0.119–0.532	0.002
2010	0.462	0.253–0.668	< 0.001	−0.729	− 0.922– −0.539	< 0.001	0.310	0.103–0.514	0.003
2011	0.541	0.333–0.746	< 0.001	−1.723	− 1.916– − 1.531	< 0.001	0.222	0.016–0.425	0.033

Initial Phase, overall P values (unadjusted): ^*age group at index date: P = 0.084; ^†income quintile: P = 0.405; ^**Ontario health region: P = 0.541; ^‡ADGs: P < 0.005; ^§stage at EAC diagnosis: P < 0.001; ^¶treatment for EAC: P < 0.001; ^€year of EAC diagnosis: P < 0.001
Continuing Care Phase, overall P values (unadjusted): ^*age group at index date: P < 0.001; ^†income quintile: P = 0.038; ^**Ontario health region: P < 0.001; ^‡ADGs: P < 0.001; ^§stage at EAC diagnosis: P = 0.794; ^¶treatment for EAC: P < 0.001; ^€year of EAC diagnosis: P < 0.001
Terminal Phase, overall P values (unadjusted): ^*age group at index date: P < 0.001; ^†income quintile: P = 0.022; ^**Ontario health region: P = 0.176; ^‡ADGs: P = 0.304; ^§stage at EAC diagnosis: P < 0.001; ^¶treatment for EAC: P < 0.001; ^€year of EAC diagnosis: P < 0.001

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