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Katherine S Virgo, PhD; Anthony M. Vernava, MD; Walter E. Longo, MD; Lowell W. McKirgan, MA; Frank E. Johnson, MD

JAMA. 1995;273(23):1837-1841.

Abstract
Objective.
—To estimate the cost of follow-up among colorectal cancer patients treated with curative intent based on the broad spectrum of surveillance strategies suggested in the literature.

Design.
—Economic analysis of the costs associated with 11 separate surveillance strategies. Charge data were obtained from the Part B Medicare Annual Data file and the Hospital Outpatient Bill file.

Setting.
—Ambulatory care.

Main Outcome Measures.
—Medicare-allowed charges and an actual-charge proxy for 5 years of follow-up after treatment for colorectal cancer patients on a nationwide basis.

Results.
—Medicare-allowed charges varied widely for the 5 years of posttreatment follow-up from a low of $561 to a high of $16 492. When Medicare-allowed charges were converted to a proxy for actual charges using a conversion ratio of 1.62, the range was $910 to $26 717, a 28-fold difference in charges.

Conclusions.
—Charges vary extensively across follow-up strategies, with no indication that higher-cost strategies increase survival or quality of life.

(JAMA. 1995;273:1837-1841)

Author Affiliations
From the Department of Surgery, Saint Louis (Mo) University Health Sciences Center (Drs Virgo, Vernava, Longo, and Johnson), and Surgical Service, St Louis (Mo) Department of Veterans Affairs Medical Center (Drs Virgo, Longo, and Johnson and Mr McKirgan).

Footnotes
The views expressed in this article are those of the authors and should not be construed as reflecting the official position of either the Department of Veterans Affairs or the Saint Louis University Health Sciences Center.

Reprint requests to Department of Surgery, Saint Louis University Health Sciences Center, 3635 Vista Ave, PO Box 15250, St Louis, MO 63110-0250 (Dr Virgo).

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