Associations Between Rehabilitation Utilization and Out-of-Pocket Costs Among Older Adults With Breast Cancer in the United States.
Rachelle Brick, Courtney P Williams, Luqin Deng and 3 others
PMID 39173732WHAT IT FOUND
Older breast cancer survivors who used rehab in the first year had higher average out-of-pocket costs than those who did not.
However, they had lower median costs and less spending on hospital stays and equipment. The overall difference was too small to be clinically meaningful.
Key findings
01Patients using rehab had higher average overall costs ($4013 vs $3783) but lower median costs than non-users.
02Rehab users had higher costs for provider visits, outpatient care, and drugs, but lower costs for inpatient care and durable medical equipment.
03All cost differences had negligible clinical significance based on effect size measures.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used 'individual cost responsibility' from claims as a proxy for actual out-of-pocket costs, which may overestimate what patients paid if they had supplemental insurance like Medigap. It could not separate the cost of the rehabilitation services themselves from other outpatient care costs. The analysis assumed that rehab use was for cancer-related disability, but could not confirm this. Results may not apply to patients with advanced/metastatic cancer or those with Medicare Advantage plans. The study did not account for informal acquisition of assistive technology or equipment.
Declared interests
One author (Dr. Stout) reports receiving honoraria from MedBridge Inc. and the Association of Cancer Care Centers. Other authors have nothing to disclose. The study was supported by non-U.S. government and N.I.H. grants.
The easy way to misread this
Do not conclude that rehabilitation causes higher financial burden for patients. While average costs were higher for rehab users, the median costs were lower, and the overall difference was statistically negligible. The higher costs were linked to more outpatient and drug usage, potentially reflecting better management of complex chronic conditions rather than a penalty for receiving therapy.