Adjuvant chemotherapy after resection in elderly Medicare and Medicaid patients with colon cancer
Adjuvant chemotherapy after resection in elderly Medicare and Medicaid patients with colon cancer
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DOI：
10.1001/archinternmed.2007.82
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发表时间：
2008-03-10
影响因子：
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通讯作者：
Fitzgerald, Timothy L.
中科院分区：
文献类型：
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作者：
Bradley, Cathy J.;Given, Charles W.;Fitzgerald, Timothy L.
背景资料：本研究调查了医疗补助登记对接受和完成辅助化疗的影响，以及肿瘤学家对不开始化疗的患者进行评估的可能性。方法：医疗补助和医疗保险管理数据与密歇根州肿瘤登记处合并，以提取1997年1月1日至12月31日期间诊断为第一个原发性结肠肿瘤切除术的患者样本，2000年（n = 4765）。我们使用未经调整和调整的logistic回归，以评估医疗补助登记和interests. Results的结果之间的关系：相对于医疗保险患者，医疗补助患者不太可能启动化疗（比值比，0.50; 95%置信区间，0.39-0.65）或完成化疗（比值比，0.52; 95%置信区间，0.31-0.85）。当样本仅限于TNM分期疾病患者时，医疗补助患者不太可能开始化疗。老年患者和合并症患者也不太可能启动或在某些情况下，完成chemotherapy.Conclusion：Medicaid登记与不同的结肠癌治疗，这可能会损害这些患者的长期生存。
Background: This study investigated the influence of Medicaid enrollment on the receipt and completion of adjuvant chemotherapy and the likelihood of evaluation by an oncologist for those patients who do not initiate chemotherapy.Methods: Medicaid and Medicare administrative data were merged with the Michigan Tumor Registry to extract a sample of patients who had resection for a first primary colon tumor diagnosed between January 1, 1997, and December 31, 2000 (n = 4765). We used unadjusted and adjusted logistic regression to assess the relationship between Medicaid enrollment and the outcomes of interest.Results: Relative to Medicare patients, Medicaid patients were less likely to initiate chemotherapy (odds ratio, 0.50; 95% confidence interval, 0.39-0.65) or complete chemotherapy (odds ratio, 0.52; 95% confidence interval, 0.31-0.85). When the sample was restricted to patients with TNM-staged disease, Medicaid patients were less likely to initiate chemotherapy. Older patients and patients with comorbidities were also less likely to initiate or, in some cases, to complete chemotherapy.Conclusion: Medicaid enrollment is associated with disparate colon cancer treatment, which likely compromises the long-term survival of these patients.