Cancer Care Visitsa

Characteristic

Sample Size

Distribution (%)b

Insurance

Medicare

2,671

49.2

Medicaid

299

2.4

Non-Medicare, private commercial

1,316

23.9

Non-Medicare, HMO, other prepaid

653

14.6

Self-pay or no charge

295

4.6

Other insurance

92

1.0

Unknown

283

4.2

a Visit was considered cancer related if the principal diagnosis was coded as a malignant neoplasm (ICD-9 140 to 208). Radiologists and radiology clinics are not included in the survey samples and ambulatory visits to these providers are not represented.

b Percentages are adjusted using sampling weights to produce national estimates.

c In the Ninth Edition of the International Classification of Diseases (ICD-9): larynx, lung = 161, 162; female breast = 174; prostate = 185; colon, rectum = 153, 154; lymphomas, leukemias = 200-208; other = all other malignancies.

d Reason for visit is the most important patient complaint, symptom, or other reason given by the patient for the visit.

e Oncolytic therapy ordered, supplied, or administered during the visit including antineoplastics; hormonal or biological response modifiers; antimetabolites; antibiotics, alkaloids, or enzymes; or DNA-damaging drugs (National Drug Code Directory Drug Classes).

f Was patient referred for this visit by another physician?

SOURCE: USDHHS, 1999a, b.

Each year, individuals with cancer incur 1.4 million hospitalizations (5 percent of all hospital discharges) (Graves and Gillum, 1997). In 1994, relatively few types of cancer accounted for the majority (52 percent) of hospitalizations—lung and other respiratory cancers, lymphomas and leukemias, and cancers of the colon and rectum, female breast, and prostate (Table 2.4). Most individuals hospitalized with a principal diagnosis of cancer are elderly (55 percent), and Medicare is the payer for most hospital care (Table 2.4). A greater share of cancer-related hospitalizations occurs in larger than in smaller hospitals (i.e., 45 percent of cancer-related hospitalization are in hospitals with 300 beds or more, and 37 percent are in hospitals with fewer than 200 beds) (Table 2.4).

With the advent of earlier hospital discharges, there has been a growing demand for services provided in the home. About 6 percent of the 2 million individuals estimated to be receiving home health care services each year have cancer (Jones and Strahan, 1997). Most indi-



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