Sapna Kaul

Mental distress and health care use among survivors of adolescent and young adult cancer: A cross-sectional analysis of the National Health Interview Survey

The current study was conducted to examine the prevalence and correlates of mental distress among survivors of adolescent and young adult (AYA) cancer and a comparison group.

Statewide Longitudinal Hospital Use and Charges for Pediatric and Adolescent Patients With Cancer

PURPOSE We investigated longitudinal hospitalization outcomes (total charges, hospital days and admissions) among pediatric and adolescent patients with cancer compared with individuals from the general population without cancer using a novel and efficient three-step regression procedure. METHODS The statewide Utah Population Database, with linkages to the Utah Cancer Registry, was used to identify 1,651 patients who were diagnosed with cancer from 1996 to 2009 at ages 0 to 21 years. A comparison group of 4,953 same-sex and -age individuals was generated from birth certificates. Claims-based hospitalization data from 1996 to 2012 were retrieved from the Utah Department of Health. Using the regression method, we estimated survival (differences due to survival) and intensity (differences due to resource accumulation) effects of the cancer diagnosis on hospitalization outcomes within 10 years after diagnosis. RESULTS At 10 years after diagnosis, on average, patients with cancer incurred

Cigarette smoking, comorbidity, and general health among survivors of adolescent and young adult cancer

51,723 (95% CI,

Barriers to follow-up care among survivors of adolescent and young adult cancer

48,100 to

A retrospective analysis of treatment‐related hospitalization costs of pediatric, adolescent, and young adult acute lymphoblastic leukemia

58,284) more in charges, spent 30 additional days (95% CI, 27.7 to 36.1 days) in the hospital, and had 5.7 (95% CI, 5.4 to 6.4) more admissions than the comparison group. Our analyses showed that the highest hospitalization burden occurred during the first 4 years of diagnosis. Patients with leukemia incurred the greatest hospitalization burden throughout the 10 years from diagnosis. Intensity effects explained the majority of differences in hospital outcomes. CONCLUSION Our results suggest that children and adolescents who were diagnosed with cancer in 2014 in the United States will incur over

The impact of language barriers and immigration status on the care experience for Spanish‐speaking caregivers of patients with pediatric cancer

800 million more in hospital charges than individuals without cancer by 2024. Interventions to reduce this burden should be explored in conjunction with improving health and survival outcomes.

Dental Care for Survivors of Adolescent and Young Adult Cancer: Special Considerations

We examined the associations between cigarette smoking, comorbidity, and general health among survivors of adolescent and young adult (AYA) cancer and a comparison group.

ReCAP: Gaps in Insurance Coverage for Pediatric Patients With Acute Lymphoblastic Leukemia

PurposeThough the need for risk-based follow-up care for survivors of adolescent and young adult (AYA) cancer has been documented, survivors often report forgoing recommended care due to cost. We sought to understand whether additional barriers to follow-up care exist for AYA survivors.MethodsWe recruited survivors who were diagnosed with cancer between the ages of 15 and 39 using the Utah Cancer Registry (UCR). Overall, 28 survivors participated in 6 focus groups held between March and May 2015 in Salt Lake City and St. George, UT. Focus group discussions focused on the reasons survivors may or may not attend recommended medical visits after completing therapy.ResultsSurvivors reported myriad barriers to follow-up medical visits, including lack of clear provider recommendation, fear of recurrent cancer diagnosis, wishing to move on with life, competing life responsibilities due to work and children, and not perceiving the need for a visit due to lack of symptoms.ConclusionsThough cost likely plays a major part in follow-up care adherence for survivors of AYA cancer, in our focus groups, participants indicated there were many other psychosocial and logistic barriers to care. Such factors play an important role in the day-to-day lives of survivors and are critical in medical decision-making.Implications for cancer survivorsSeveral factors impede follow-up care adherence for survivors of AYA cancer that are amenable to interventions, including clearer provider recommendations, flexible appointment times, and childcare availability in clinics.

Estimating the value of the World Heritage Site designation: a case study from Sagarmatha (Mount Everest) National Park, Nepal

This retrospective study examined the longitudinal hospital outcomes (costs adjusted for inflation, hospital days, and admissions) associated with the treatment of pediatric, adolescent, and young adult acute lymphoblastic leukemia (ALL). Patients between one and 26 years of age with newly diagnosed ALL, who were treated at Primary Childrens Hospital (PCH) in Salt Lake City, Utah were included. Treatment and hospitalization data were retrieved from system‐wide cancer registry and enterprise data warehouse. PCH is a member of the Childrens Oncology Group (COG) and patients were treated on, or according to, active COG protocols. Treatment‐related hospital costs of ALL were examined by computing the average annual growth rates (AAGR). Longitudinal regressions identified patient characteristics associated with costs. A total of 505 patients (46.9% female) were included. The majority of patients had B‐cell lineage ALL, 6.7% had T‐ALL, and the median age at diagnosis was 4 years. Per‐patient, first‐year ALL hospitalization costs at PCH rose from

Cost‐related medication nonadherence among adolescent and young adult cancer survivors

24,197 in 1998 to