The effect of medicare health care delivery systems on survival for patients with breast and colorectal cancer

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
Robert S KirsnerJames D Wilkinson

Abstract

Two of the most common types of health care delivery systems in the U.S. are fee-for-service (FFS) and managed care systems such as health maintenance organizations (HMO). Differences may exist in patient outcomes depending on the health care delivery system in which they are enrolled. We evaluated differences in the survival of patients with breast and colorectal cancer at diagnosis between the two Medicare health care delivery systems (FFS and HMO). We used a linkage of two national databases, the Medicare database from the Centers for Medicare and Medicaid Services, and the National Cancer Institute's Surveillance, Epidemiology, and End Results program database, to evaluate differences in demographic data, stage at diagnosis, and survival between breast and colorectal cancer over the period 1985 to 2001. Medicare patients enrolled in HMOs were diagnosed at an earlier stage of diagnosis than FFS patients. HMO patients diagnosed with breast and colorectal cancer had improved survival, and these differences remained even after controlling for potential confounders (such as stage at diagnosis, age, race, socioeconomic status, and marital status). Specifically, patients enrolled in HMOs had 9% greater survival in hazards ratio if...Continue Reading

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Citations

Nov 8, 2012·Journal of Gastrointestinal Cancer·Sacha Satram-HoangEdward McKenna
Jul 2, 2011·Journal of the National Cancer Institute·Jennifer L PatnaikDana Dabelea
Jun 15, 2013·Inflammatory Bowel Diseases·Christian P SelingerUNKNOWN Sydney IBD Cohort Study Group
Nov 29, 2011·Health & Place·Neng WanJohn P Tiefenbacher
Aug 22, 2013·Journal of the National Cancer Institute. Monographs·Paul A FishmanRamzi G Salloum

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