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Supportive health education reduces health care utilization and costs in Latinas with breast cancer and their caregivers

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Abstract

Purpose

To compare costs and relative cost savings from reductions in unscheduled health services use for two 8-week psychosocial interventions (telephone interpersonal counseling [TIPC], supportive health education [SHE]) delivered by telephone to Latinas with breast cancer and their informal caregivers. Cost information is required before adopting supportive care interventions as part of routine care. There is limited information on costs of producing supportive care interventions or their impact on service use.

Methods

Latinas and their caregivers were randomized to either TIPC or SHE. At baseline and month 4, hospitalizations and urgent care and emergency department (ED) visits in the previous month were recorded. These were compared by trial arm for 181 survivors and 169 caregivers using logistic regression, adjusting for age and health services use at baseline.

Results

Total cost per 100 survivors was $28,695 for SHE and $27,399 for TIPC. Urgent care and ED visits were reduced for survivors in SHE versus TIPC (odds ratio (OR) = 0.31, 95% confidence interval (CI) [0.12, 0.88], p = .03). For hospitalizations, OR for SHE versus TIPC was 0.59, 95% CI [0.26, 1.37], p = .07. There were no differences between trial arms for caregiver health services use. Cost savings for SHE versus TIPC from reductions in health services use per 100 survivors ranged from $800 for urgent care to $17,000 for ED visits and $13,000 for hospitalizations.

Conclusions

Based on this evidence, SHE can be a cost-saving supportive care solution that benefits not only survivors and caregivers, but also oncology practices reimbursed through episodes of care.

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Data availability

De-identified data would be shared after IRB approvals were obtained with the consent of the collaborators.

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Acknowledgments

We thank the research staff Maria Figueroa, Karina Othon-Tapia, Xochitl Gaxiola, Alice Pasvogel, Mary Pentland, and Molly Hadeed, the community providers who referred survivors to the study and the study participants.

Code availability

Coding of the data would be shared with the de-identified data after IRB approval and with the consent of the collaborators.

Funding

This research was supported by a grant # RSG-12-120-01-CPPB from the American Cancer Society to Terry Badger.

Author information

Authors and Affiliations

  1. College of Nursing, University of Arizona, Tucson, AZ, 85721, USA

    Terry A. Badger

  2. Department of Psychiatry, Michigan State University, East Lansing, MI, 48824, USA

    Alla Sikorskii

  3. Department of Communication, University of Arizona, Tucson, AZ, 85721, USA

    Chris Segrin

  4. College of Nursing, Michigan State University, East Lansing, MI, 48824, USA

    Charles W. Given

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  1. Terry A. Badger
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Correspondence to Terry A. Badger.

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The authors declare that they have no conflicts of interest.

Ethics approval

The University of Arizona Institutional Review Board approved this study (protocol 1100000136).

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Badger, T.A., Sikorskii, A., Segrin, C. et al. Supportive health education reduces health care utilization and costs in Latinas with breast cancer and their caregivers. Support Care Cancer 29, 1225–1233 (2021). https://doi.org/10.1007/s00520-020-05593-9

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  • DOI: https://doi.org/10.1007/s00520-020-05593-9

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