Health Service Use in the Elderly with Cancer

描述（由申请人提供）：乳腺癌、结直肠癌和前列腺癌等常见癌症的5年相对生存率较高，这意味着这些癌症患者应接受推荐的预防服务，以及对其他共存慢性病的高质量护理。该项目将测试在患有癌症的美国老年人中，推荐的临床预防服务和护理质量指南是否与未患癌症的老年人一样频繁。我们将研究的服务是：（a）流感免疫;（B）糖尿病护理质量措施：每年测定血清血红蛋白Alc、血清低密度脂蛋白、眼科检查和肾病监测;（c）乳腺癌、结肠直肠癌和前列腺癌筛查。我们将研究老年医疗保险按服务收费的受益人确定的监测，流行病学和最终结果（SEER）-医疗保险链接数据库与事件乳腺癌，结肠直肠癌或前列腺癌在1999年，或事件乳腺癌或前列腺癌在1996年或1997年。具体来说，我们将：1。比较新诊断的癌症患者在完成初始治疗后的一段时间内对推荐护理的利用率与居住在SEER地区的5%老年美国人中没有癌症的利用率; 2.在有足够统计效力的情况下，我们将比较多数人口（非西班牙裔白人）与少数人口群体（非西班牙裔黑人、西班牙裔和亚洲人）对服务的使用情况。 此外，我们将对诊断为原位癌或局部癌的患者与诊断为局部或远处疾病的患者进行分层子集分析。通过这项研究，提供者将知道是否需要更加重视向所有患有这些类型癌症的人或人口中的某些亚群体提供这些服务。

DESCRIPTION (provided by applicant): High 5-year relative survival rates for common cancers types such as breast, colorectal and prostate, mean that persons with these cancers should receive recommended preventive services, as well a high quality care for other co-existing chronic diseases. This project will test if recommended clinical preventive services and quality of care guidelines are met as frequently among elderly Americans who develop cancer as among elderly persons without cancer. The services we will study are (a) influenza immunization; (b) the diabetes quality of care measures: annual determination of serum hemoglobin Alc, serum low-density lipids, eye examination, and monitoring for nephropathy; and (c) screening for breast, colorectal and prostate cancer. We will study elderly Medicare fee-for-service beneficiaries identified in the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database with incident breast, colorectal or prostate cancer in 1999, or incident breast or prostate cancer in 1996 or 1997. Specifically, we will: 1. Compare the rates of utilization of the recommended care in the newly diagnosed cancer patients in the period after the completion of initial treatment to the rates in a 5% sample of elderly Americans living in SEER areas who do not have cancer; 2. where sufficient statistical power exists, we will compare the use of services in the majority population (non-Hispanic whites) with the minority population groups: non-Hispanic blacks, Hispanics and Asians. In addition, we will do a stratified sub-set analysis of use of these measures among persons who are diagnosed with carcinoma in situ or localized cancer compared with those with regional or distant disease. As a result of this study, providers will know if an increased emphasis needs to be placed on providing these services to all persons with these types of cancer or to certain sub-groups of the population.