Survival and Treatment for Colorectal Cancer Medicare Patients in Two Group/Staff Health Maintenance Organizations and the Fee-for-Service Setting  

Oleh:

Merrill, Ray M. ; Brown, Martin L. ; Potosky, Arnold L. ; Riley, Gerald ; Taplin, Stephen H. ; Barlow, William E. ; Fireman, Bruce H. ; Permanente, Kaiser

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Medical Care Research and Review vol. 56 no. 2 (Jun. 1999), page 177-196.
Topik: Cancer cases.
Fulltext: 177MCR56.2.pdf (91.4KB)

Isi artikel

The current study compares treatment use and long-term survival in colorectal cancer patients between Medicare beneficiaries enrolled in two large prepaid group/staff health maintenance organizations (HMOs) and the fee-for-service (FFS) setting. The study is based on 15,352 colorectal cancer cases diagnosed between 1985 and 1992 and followed through 1995. Survival differences between theHMOand FFS cases were assessed using Cox regression. Treatment differences were evaluated using logistic regression. HMO cases had a lower overall mortality than did FFS cases but not a significantly lower colorectal cancer-specific mortality. Use of surgical resection was similar betweenHMOand FFS cases. However, rectal cancer cases in the HMOs were more likely to receive postsurgical radiation therapy than FFS cases. Superior overall survival in the HMOs may be the result of increased colorectal cancer screening, greater use of adjuvant therapies, and selection of healthier individuals.

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