Survival and treatment for colorectal cancer medicare patients in two group staff health maintenance organizations and the fee-for-service setting
Survival and treatment for colorectal cancer medicare patients in two group staff health maintenance organizations and the fee-for-service setting
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DOI：
10.1177/107755879905600204
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发表时间：
1999-06-01
影响因子：
2.5
通讯作者：
Fireman, BH
中科院分区：
文献类型：
--
作者：
Merrill, RM;Brown, ML;Fireman, BH
目前的研究比较了两个大型预付费团体/研究健康维护组织（HMO）和收费服务（FFS）设置的医疗保险受益人之间的结直肠癌患者的治疗使用和长期生存。该研究基于1985年至1992年诊断的15，352例结直肠癌病例，并随访至1995年。使用考克斯回归评估HMO和FFS病例之间的生存差异。使用logistic回归评价治疗差异。HMO病例的总体死亡率低于FFS病例，但结直肠癌特异性死亡率并没有显著降低。HMO和FFS病例之间手术切除的使用相似。然而，HMO中的直肠癌病例比FFS病例更有可能接受术后放射治疗。HMO的上级总生存率可能是增加结直肠癌筛查、更多地使用辅助治疗和选择更健康个体的结果。
The current study compares treatment use and long-term survival in colorectal cancer patients between Medicare beneficiaries enrolled in two large prepaid group/study 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 the HMO and 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 between HMO and 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.