The NonCancer Care of Elderly Colorectal Cancer Patients

老年结直肠癌患者的非癌症护理

基本信息

批准号：
7030281
负责人：
Laura-Mae Baldwin
金额：
$ 40.43万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-04-15 至 2009-02-28
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Study Objectives and Specific Aims: This study's objective is to ensure that elderly cancer patients receive the highest quality care for their non-cancer conditions in conjunction with their cancer care, thereby improving their quality of life and maximizing their survival. Most elderly cancer patients enter the cancer care system with a broad range of medical conditions. Little information is available on cancer patients' receipt of non-cancer care. The specific aims of this study are: 1) to compare the receipt of non-cancer care (recommended preventive care, care for chronic medical conditions, and elective surgical procedures) among colorectal cancer patients compared to an age/sex matched non-cancer cohort, 2) to compare receipt of noncancer care among colorectal cancer patients before and after their cancer diagnosis, 3) to identify the patient, tumor, physician/health system, and environmental factors associated with non-cancer care use among colorectal cancer patients, 4) to determine whether receipt of recommended preventive or chronic disease care is associated with improved overall survival among colorectal cancer patients, and 5) to identify the physician specialties providing the most care to colorectal cancer patients. Research Design and Methods: This study will use a retrospective cohort design to evaluate receipt of non-cancer care among colorectal cancer patients and non-cancer controls. This secondary database analysis will use Surveillance, Epidemiology, and End Results (SEER) program data on stage I-III colorectal cancer patients diagnosed between 1992 and 1999 linked with 1991-2001 Medicare claims data and the American Medical Association Master file. Data for controls will be provided by the 1991-2001 Medicare claims for the 5 percent sample of Medicare beneficiaries living in the SEER areas. We first will define preventive, chronic disease, and elective surgical care measures using claims data, then compare non-cancer care both before and after cancer diagnosis, as well as between the cancer and non-cancer cohorts. We will use logistic regression analyses to identify the factors associated with receipt of non-cancer care, and survival analysis to determine whether there is an association between receipt of preventive and diabetic care services and survival.

描述（由申请人提供）：研究目标和特定目的：本研究的目标是确保老年癌症患者与癌症护理结合其非癌症状况获得最高质量的护理，从而改善其生活质量并最大程度地提高其生存。大多数老年癌症患者都以广泛的医疗状况进入癌症护理系统。关于癌症患者获得非癌症护理的信息很少。这项研究的具体目的是：1）比较结直肠癌患者的非癌症护理（建议的预防性护理，护理慢性病护理，慢性病护理和选择性手术程序）与年龄/性别相匹配的非癌症同伴相比，2）以比较与卫生疗法之前和疾病之后的环境相关性，3）结直肠癌患者中的非癌症护理使用，4）确定收到推荐的预防性或慢性病护理是否与结直肠癌患者的总体生存率改善有关，而5）则确定医生专业为结直肠癌患者提供最多的护理。研究设计和方法：本研究将使用回顾性队列设计来评估结直肠癌患者和非癌症对照中非癌症护理的收到。该次要数据库分析将使用监视，流行病学和最终结果（SEER）计划数据数据数据数据数据数据数据数据数据，在1992年至1999年间诊断为1992年至1999年之间的1991 - 2001年Medicare索赔数据和美国医学协会的大师文件之间。控制措施的数据将由1991 - 2001年的Medicare索赔提供，该索赔将为居住在SEER地区的医疗保险受益人的5％样本提供。我们首先将使用索赔数据定义预防性，慢性疾病和选择性手术护理指标，然后比较癌症诊断前后的非癌症护理，以及癌症和非癌症队列之间。我们将使用逻辑回归分析来识别与接收非癌症护理相关的因素，并确定收到预防和糖尿病护理服务和生存之间是否存在关联。