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Receipt of general medical care by colorectal cancer patients: a longitudinal study.
- Source :
-
Journal of the American Board of Family Medicine : JABFM [J Am Board Fam Med] 2011 Jan-Feb; Vol. 24 (1), pp. 57-68. - Publication Year :
- 2011
-
Abstract
- Background: cancer diagnosis has the potential to overshadow patients' general medical care needs. This study examined changes in general medical care among elderly patients with colorectal cancer (CRC), from before diagnosis through long-term survival.<br />Methods: this longitudinal cohort study used 1993 to 1999 Surveillance, Epidemiology, and End Results and 1991 to 2001 Medicare claims data for 22,161 patients with stage 0 to 3 CRC and 81,669 controls aged 67 to 89 years. Outcomes were preventive services (influenza vaccination, mammography) and, among diabetics, HgbA1c and lipid testing in the phase before diagnosis, the phase after initial treatment, the surveillance phase, and the survival care phase. Logistic regression provided adjusted relative risks of care receipt for patients with stage 0 to 1 cancer, stage 2 to 3 cancer, and no cancer.<br />Results: in the phase before diagnosis through the surveillance phase, patients with stage 0 to 1 CRC had the highest annual preventive service rates. Patients with stage 2 to 3 CRC made substantial gains in preventive service use, especially mammography, after diagnosis (influenza vaccination, 46.4% before diagnosis to 50.2% after initial treatment; mammography, 31.4% before diagnosis to 40.2% after initial treatment) but not in diabetes care (eg, HgbA1c, 53.4% before diagnosis to 54.9% after initial treatment).<br />Conclusions: CRC diagnosis seems to facilitate receipt of preventive services but not diabetes care for elderly, later-stage patients. Additional strategies such as strengthening partnerships between cancer patients, primary care physicians, and cancer care physicians are needed to improve care for a chronic disease like diabetes.
- Subjects :
- Aged
Aged, 80 and over
Colorectal Neoplasms pathology
Colorectal Neoplasms prevention & control
Confidence Intervals
Diabetes Mellitus
Disease Management
Early Detection of Cancer
Female
Humans
Lipids
Longitudinal Studies
Male
Mammography
Preventive Health Services statistics & numerical data
Primary Health Care statistics & numerical data
Quality of Health Care standards
Registries
Risk
Treatment Outcome
United States
Colorectal Neoplasms mortality
Preventive Health Services methods
Primary Health Care methods
Quality of Health Care statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1558-7118
- Volume :
- 24
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of the American Board of Family Medicine : JABFM
- Publication Type :
- Academic Journal
- Accession number :
- 21209345
- Full Text :
- https://doi.org/10.3122/jabfm.2011.01.100080