Brayton, K.M., Hirsch, A.T., O'Brien, P.J., Cheville, A., Karaca-Mandic, P., & Rockson, S.G. (2014). Lymphedema prevalence and treatment benefits in cancer: Impact of a therapeutic intervention on health outcomes and costs. PLOS One, 9, e114597.
To examine the insurance data of cancer survivors to determine lymphedema prevalence and to assess the affect on specific clinical health outcomes and healthcare costs after the receipt of a pneumatic compression device (PCD) among the identified study group of cancer survivors with lymphedema
The researchers performed a retrospective analysis of health claims data from 2007–2013. D-identified administrative health claims data from deidentified Normative Health Information (dNHI) database (34 million insured) were used through OptumInsight. Researchers did not have access to the data but rather instructed Optum employees to cull the data.
A retrospective study of insurance data from 2007–2013. The researchers compared the rate of identified clinical healthcare outcomes and their costs in each setting for the year prior to the receipt of a PCD to the rates and costs after receipt of the PCD.
After the sample was identified, the affect of the receipt of the PCD was determined by searching for specific claims codes and their costs during the 12 months before and after receipt of the PCD. Specific health outcomes, such as hospitalization, outpatient visits, physical therapy, episodes of cellulitis, and courses of lymphedema physical therapy, were determined by the American Medical Association place of service codes, and the clinical costs were designated as lymphedema related if the primary or secondary diagnoses were ICD-9: 457.0, 457.1, 757.0. Total cost was the sum of the payments for lymphedema claims. Continuous variables were tested pre PCD minus post PCD with a paired t test.
Lymphedema prevalence among cancer survivors continues to be defined. Whether a PCD improved healthcare outcomes or reduced healthcare costs is unclear. Nevertheless, healthcare outcomes and costs were reduced. A PCD may benefit outcomes and reduce costs. Even with the limitations of this study, lymphedema needs to be diagnosed, treated early, and managed to reduce the disease burden.