Predictors of use of health care services among elderly lung cancer patients: the first year after diagnosis
Predictors of use of health care services among elderly lung cancer patients: the first year after diagnosis
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DOI：
10.1007/s00520-005-0877-5
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发表时间：
2006-03-01
影响因子：
3.1
通讯作者：
Given, B
中科院分区：
文献类型：
--
作者：
Kurtz, ME;Kurtz, JC;Given, B
在这项研究中，我们调查了277例老年肺癌患者在确诊后第一年内对医生、医院和急诊室服务利用的预测因素。通过患者访谈和患者自填问卷相结合，在四个时间间隔获得数据：基线（第1波）、3个月（第2波）、6个月（第3波）和12个月（第4波）。在277例患者中，242例提供了第1波数据，209例提供了第2波数据，157例提供了第3波数据，115例提供了第4波数据。使用症状体验量表（从37种癌症相关症状列表中选择的简单症状计数）评估症状学，并使用医学结局研究36项简表健康调查评估身体功能。分别对活性治疗期（0-6个月）和持续治疗期（6-12个月）进行协方差模型分析，以确定年龄、性别、合并症、生存期、治疗状态、疾病分期、癌症部位、身体功能和症状计数与医生访视、住院天数和急诊室访视的相关性。在积极治疗期间，身体功能较差的患者报告了更多的住院天数（p=0.002）和更多的急诊室就诊（p=0.013），而男性报告的急诊室就诊（p=0.032）和住院天数（p=0.006）比女性更频繁。报告更多症状的患者也报告了更多的医生就诊（p=0.020）。在持续护理期间，身体功能与住院天数（p=0.005）和急诊室就诊（p=0.003）有类似的关系，晚期疾病患者报告的医生就诊次数多于早期疾病患者（p=0.003）。
In this study, we investigated predictors of utilization of physician, hospital, and emergency room services in a sample of 277 elderly patients during the first year following a diagnosis of lung cancer. Data were obtained by a combination of patient interview and patient self-administered questionnaire at four intervals: baseline (wave 1), 3 months (wave 2), 6 months (wave 3), and 12 months (wave 4). Of the 277 patients, 242 provided data at wave 1, 209 at wave 2, 157 at wave 3, and 115 at wave 4. Symptomatology was assessed with the Symptom Experience Scale (simple count of symptoms present, chosen from a list of 37 cancer-related symptoms), and physical functioning was assessed with the Medical Outcomes Study 36-Item Short Form Health Survey. Analysis of covariance models were implemented separately for the active treatment period (0-6 months) and the continuing care period (6-12 months) to determine how age, gender, comorbidity, length of survival, treatment status, stage of disease, cancer site, physical functioning, and symptom count were related to physician visits, nights in hospital, and emergency room visits. During the active treatment period, patients with worse physical functioning reported more hospital nights (p=0.002) and more emergency room visits (p=0.013), while men reported more frequent emergency room visits (p=0.032) and more nights in hospital (p=0.006) than women. Patients reporting more symptoms also reported more physician visits (p=0.020). During the continuing care period, physical functioning had a similar relation to hospital nights (p=0.005) and emergency room visits (p=0.003), and patients with late-stage disease reported more physician visits than patients with early-stage disease (p=0.003).