Advisory Committee Chair
Robert Weech-Maldonado
Advisory Committee Members
Larry Hearld
Bisakha Sen
Vamsidhar Velcheti
Document Type
Dissertation
Date of Award
2022
Degree Name by School
Executive Doctor of Science (DSc) School of Health Professions
Abstract
The COVID-19 pandemic has derailed normal operations in the health care delivery systems in the United States (US) and globally, providing prioritized care to patients seeking acute management of the novel coronavirus and its complications. Simultaneously, cancer screening tests have decreased, resulting in decreased rates of cancer diagnoses and referrals to oncologists. The purpose of this study was to assess time to treatment initiation (TTI) with systemic cancer therapy in patients with newly diagnosed metastatic lung cancer, metastatic lung cancer-related and total healthcare resource utilization (HCRU) and costs during the pandemic/post-pandemic period compared with the pre-pandemic period. The retrospective claims study included patients greater than 18 years of age with commercial, commercial self-pay, and Medicare Advantage insurance. Analyses were conducted from January 1, 2019 to February 29, 2020, pre-pandemic period, and compared to March 1, 2020 to April 30, 2021, the pandemic/post-pandemic period. Cox proportional hazards models were used to describe and investigate the difference in TTI in pre-pandemic and pandemic/post-pandemic time periods. Multivariable logistic regression models were used to assess the probability of having a hospital, ER or hospice/palliative care visit. Multivariable linear regression models were used to see differences in the utilization of outpatient visits. Multivariable Generalized Linear Models with a log transformation and gamma distribution were used iv to see if there were differences in healthcare costs. There was no difference in TTI between the pre-pandemic and pandemic/post-pandemic time periods. The odds of receiving outpatient and inpatient hospice/palliative care, inpatient and ER care were lower in the pandemic/post-pandemic period. Per patient per month (PPPM) metastatic lung cancer-related and total costs were higher in the pandemic/post-pandemic time period. This is the first study assessing the impact of the COVID-19 pandemic on TTI, HCRU and costs in patients with newly diagnosed metastatic lung cancer.
Recommended Citation
Zyczynski, Teresa M., "Assessing the Impact of the COVID-19 Pandemic on Metastatic Lung Cancer Time to Treatment Initiation, Health Care Resource Utilization, and Costs in the United States" (2022). All ETDs from UAB. 151.
https://digitalcommons.library.uab.edu/etd-collection/151