Technology Diffusion in Cancer: Geographic Variations, Facilitators, Outcomes, and Costs

癌症技术扩散：地理差异、促进因素、结果和成本

• 批准号: 9281711
• 负责人: Ya-Chen Tina Shih
• 金额: $ 27.36万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9281711
• 关键词: Accounting; Address; Area; Attention; Cancer Patient; Capital; Cause of Death; Cessation of life; Characteristics; Clinical; Colorectal; Data; Databases; Demographic Aging; Diffuse; Diffusion; Disease; Economic Inflation; Economics; Elderly; Equipment; Evaluation; Expenditure; Female Breast Carcinoma; Female breast; Guideline Adherence; Guidelines; Health; Health Services Research; Healthcare; Heart Diseases; Institute of Medicine (U.S.); Intensity-Modulated Radiotherapy; Lymphoma; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Medical; Medical Oncology; Medicare; Medicine; Modality; Modeling; Modern Medicine; Operative Surgical Procedures; Outcome; Pattern; Pharmaceutical Preparations; Policies; Policy Maker; Provider; Public Health; Radiation; Radiation Oncology; Radiosurgery; Reporting; Research; Robotics; Science; Side; Specialist; Surgical Oncology; System; Technology; Technology Assessment; Testing; United States; Variant; cancer care; cancer therapy; care delivery; cohort; cost; density; design; experience; financial incentive; geographic difference; health economics; heart disease prevention; insight; member; multidisciplinary; new technology; novel therapeutics; oncology; policy implication; population based; standard of care; targeted treatment; technology diffusion; theories; trend

PROJECT SUMMARY Cancer is the second leading cause of death in the United States, accounting for approximately 25% of deaths. The national medical expenditures of cancer reached $125 billion in 2010, and are projected to increase to $158 billion by 2020. A recent Institute of Medicine report, entitled “Delivering high-quality cancer care: Charting a new course for a system in crisis,” expressed major concerns over the unsustainable increase in the cost of cancer care, identifying rapid diffusion of new technologies and the aging demographic as key cost drivers. The objective of the proposed study is to examine the impact of technology diffusion in medical, radiation, and surgical oncology on the costs and outcomes of cancer care. Specific aims of the study are: (1) to describe the pattern of technology diffusion in medical, radiation, and surgical oncology in the top five most expensive cancers and assess the geographic variation of the diffusion pattern; (2) to examine factors associated with the diffusion of new technologies and those that contribute to the geographic variations in new technology diffusion; (3) to evaluate the impact of the diffusion of new oncologic technologies on health outcomes and whether the impact would be modified by guideline adherence; and (4) to estimate the effect of the diffusion of new oncologic technologies on the cost of cancer care and geographic variation in healthcare spending, and to explore for each cancer whether these new technologies are substitute or complementary to existing treatment. We will address our research questions using a cohort of cancer patients extracted from the SEER-Medicare and MarketScan databases, focusing on the top five most expensive cancers: female breast, colorectal, lymphoma, lung, and prostate cancer. Our study will provide a comprehensive evaluation of the current state of technology diffusion for all modalities involved in the treatment of cancer, paying special attention to market and organizational characteristics tied to providers’ financial incentives. The choice of cancer to study technology diffusion offers a unique opportunity to understand the complicated interactions between new and existing technologies and allows us to explore the substitution or complementary effect of new technologies, both within the same class of technology and across classes. Findings from our study will assist policy makers in the design and planning dissemination and implementation strategies to maximize the benefit of effective new treatments while taking into consideration of the cost implications to the cancer care delivery system.

项目摘要 癌症是美国第二大死亡原因，约占死亡的25％。 国家癌症的国家医疗支出在2010年达到1,250亿美元，预计将增加到 到2020年，1580亿美元。最近的一份医学研究所报告，标题为“提供高质量的癌症护理： 为危机中的系统制定新课程，”对不可持续的增加表示了重大关注 癌症护理的成本，确定新技术的快速扩散和老化的人口统计 司机。拟议的研究的目的是检查技术扩散在医疗中的影响， 辐射和外科肿瘤学关于癌症护理的成本和结果。 该研究的具体目的是：（1）描述医疗，辐射和 前五名最昂贵的癌症中的手术肿瘤学，并评估扩散的地理变化 图案; （2）检查与新技术的扩散相关的因素以及有助于的因素 新技术扩散的地理变化； （3）评估新扩散的影响 关于健康结果的肿瘤学技术以及是否会通过指南遵守来改变影响； （4）估计新肿瘤技术扩散对癌症护理成本和 医疗保健支出的地理差异，并探索每种癌症是否这些新技术 是替代或互补的现有治疗方法。我们将使用队列解决我们的研究问题 从Seer-Medicare和MarketScan数据库中提取的癌症患者，重点是前五名 最昂贵的癌症：女性乳房，结直肠癌，淋巴瘤，肺和前列腺癌。 我们的研究将对各种方式的当前技术传播状态进行全面评估 参与癌症的治疗，特别关注与市场和组织特征相关的组织特征 提供者的经济激励措施。研究技术扩散的癌症选择为 了解新技术和现有技术之间的复杂互动，并使我们能够探索 在同一技术和跨越的技术中，新技术的替换或完全效果 课程。我们研究的发现将协助决策者进行设计和计划的传播和 实施策略，以最大程度地提高有效的新疗法的好处 癌症护理输送系统的成本影响。