Preventive Health Care Use in Elderly Cancer Survivors

描述（由申请人提供）

DESCRIPTION (provided by applicant) The high 5-year relative survival rates for many cancer types mean that cancer survivors should receive the recommended clinical preventive services, as well as quality health care for other co-existing chronic diseases. It is important, as well as consistent with the Healthy People 2010 objectives, that older Americans, including those of each race and ethnic group, receive these services irregardless of whether they have survived cancer, or not. This study will test if recommended clinical preventive services, including cancer screening, as well as diabetes quality of care guidelines, are met as frequently among elderly Americans who have survived breast, uterine, colon and rectal, bladder, or prostate cancer as among elderly persons without cancer. The services we will study are (a) influenza immunization; (b) the American Diabetes Association's recommended diabetes quality of care measures: the determination of serum hemoglobin Alc (HbA1 c) and low-density lipids (LDL-C), eye examination, and testing for diabetic nephropathy in persons who have diabetes, 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, uterine, colorectal, bladder or prostate cancer who survived 5 to 25 years We will determine the use of appropriate clinical preventive and diabetes care services in the four-year period from January 1, 1998 through December 31, 2001. Specifically, we will (1) compare the rates of utilization of the recommended care in the cancer survivors to the rates in a 5 percent sample of elderly Americans living in SEER areas who have not had cancer; and (2) compare the use of services in the majority population (non-Hispanic whites) with the minority population groups: non-Hispanic blacks, Hispanics and Asians. We will do a sub-set analysis of use of these services among persons who are diagnosed with localized cancer compared with those with regional or distant disease. Important covariates in all analyses include the type(s) of initial treatment received (surgery or radiation), patient sociodemographic variables, comorbidities, and the specialties of the physicians providing care.