Survival and Treatment for Colorectal Cancer Medicare Patients in Two Group/Staff Health Maintenance Organizations and the Fee-for-Service Setting

Merrill, Ray M.; Brown, Martin L.; Potosky, Arnold L.; Riley, Gerald F.; Taplin, Stephen H.; Barlow, William; Fireman, Bruce

doi:10.1177/107755879905600204

Cited by 42 publications

(38 citation statements)

References 65 publications

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“…[19][20][21][22]41 Studies reported by Retchin et al 20,21 and Merrill et al 41 were restricted to patients insured by Medicare, a group for which we also found no differences in outcomes. Studies reported by Francis et al 22 and by Vernon et al 19 were not population based and were restricted to patients residing in single metropolitan areas (Seattle and Houston, respectively) that may not be representative of other parts of the country.…”

Section: Discussionmentioning

confidence: 55%

Effects of health insurance and race on colorectal cancer treatments and outcomes

Roetzheim

Pal²,

Gonzalez³

et al. 2000

Am J Public Health

214

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OBJECTIVES: We hypothesized that health insurance payer and race might influence the care and outcomes of patients with colorectal cancer. METHODS: We examined treatments received for all incident cases of colorectal cancer occurring in Florida in 1994 (n = 9551), using state tumor registry data. We also estimated the adjusted risk of death (through 1997), using proportional hazards regression analysis controlling for other predictors of mortality. RESULTS: Treatments received by patients varied considerably according to their insurance payer. Among non-Medicare patients, those in the following groups had higher adjusted risks of death relative to commercial fee-for-service insurance: commercial HMO (risk ratio [RR] = 1.40; 95% confidence interval [CI] = 1.18, 1.67; P = .0001), Medicaid (RR = 1.44; 95% CI = 1.06, 1.97; P = .02), and uninsured (RR = 1.41; 95% CI = 1.12, 1.77; P = .003). Non-Hispanic African Americans had higher mortality rates (RR = 1.18; 95% CI = 1.01, 1.37; P = .04) than non-Hispanic Whites. CONCLUSIONS: Patients with colorectal cancer who were uninsured or insured by Medicaid or commercial HMOs had higher mortality rates than patients with commercial fee-for-service insurance. Mortality was also higher among non-Hispanic African American patients.

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Section: Discussionmentioning

confidence: 55%

Effects of health insurance and race on colorectal cancer treatments and outcomes

Roetzheim

Pal²,

Gonzalez³

et al. 2000

Am J Public Health

214

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“…34 Previous studies have indicated that Medicare beneficiaries enrolled in health maintenance organization plans have better survival than patients enrolled in fee-for-service plans. 38,39 However, in a study that was restricted to patients who were enrolled in both Medicaid and Medicare at the time of their colorectal cancer diagnosis, no racial difference in survival was observed. 40 Dignam et al reported no significant racial difference in cancer-specific survival among patients with colon cancer (HR, 1.08; 95% CI, 0.94-1.25) or rectal cancer (HR, 1.25; 95% CI, 0.94-1.66) who were enrolled in the National Surgical Adjuvant Breast and Bowel Project trials, in which treatment regimens are controlled more rigorously.…”

Section: Discussionmentioning

confidence: 99%

Racial differences in tumor stage and survival for colorectal cancer in an insured population

Doubeni

Field

Buist

et al. 2006

Cancer

110

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BACKGROUND: Despite declining death rates from colorectal cancer (CRC), racial disparities have continued to increase. In this study, the authors examined disparities in a racially diverse group of insured patients. METHODS: This study was conducted among patients who were diagnosed with CRC from 1993 to 1998, when they were enrolled in integrated healthcare systems. Patients were identified from tumor registries and were linked to information in administrative databases. The sample was restricted to non-Hispanic whites (n = 10,585), non-Hispanic blacks (n = 1479), Hispanics (n = 985), and Asians/Pacific Islanders (n = 909). Differences in tumor stage and survival were analyzed by using polytomous and Cox regression models, respectively. RESULTS: In multivariable regression analyses, blacks were more likely than whites to have distant or unstaged tumors. In Cox models that were adjusted for nonmutable factors, blacks had a higher risk of death from CRC (hazard ratio [HR], 1.17; 95% confidence interval [95% CI], 1.06-1.30). Hispanics had a risk of death similar to whites (HR, 1.04; 95% CI, 0.92-1.18), whereas Asians/Pacific Islanders had a lower risk of death from CRC (HR, 0.89; 95% CI, 0.78-1.02). Adjustment for tumor stage decreased the HR to 1.11 for blacks, and the addition of receipt of surgical therapy to the model decreased the HR further to 1.06. The HR among Hispanics and Asians/Pacific Islanders was stable to adjustment for tumor stage and surgical therapy. CONCLUSIONS: The relation between race and survival from CRC was complex and appeared to be related to differences in tumor stage and therapy received, even in insured populations. Targeted interventions to improve the use of effective screening and treatment among vulnerable populations may be needed to eliminate disparities in CRC

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“…[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Only a handful of studies have addressed racial disparities in survival for colon cancer by adequately incorporating both treatment and SES 31,33,35,37 in addition to factors like cancer stage, tumor grade, and comorbid conditions. Among this limited number of studies, [28][29][30][31][32][33][34][35][36][37][38][39] the findings have been inconsistent. One of the main reasons for these inconsistent findings may be that previous studies had relatively small numbers of study patients.…”

mentioning

confidence: 99%

Meta‐analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer

Meyer

Franzini

2007

Cancer

100

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Patients with cystic fibrosis (CF) often experience acute pulmonary exacerbations (APE) and may be treated with a wide variety of intravenous antibiotics. The aim of this review is to provide an evidence‐based summary of pharmacokinetic/pharmacodynamic (PK/PD), tolerability, and efficacy studies utilizing the intravenous (IV) polymixin antibiotic colistimethate sodium (CMS) in the treatment of APE and to identify areas where further study is warranted. Currently, there is not an international standard on the labeling of CMS products. As a result, this has lead to confusion in the interpretation of the literature with respect to efficacy, tolerance, and optimal dosing strategy. The dosing ranges of IV CMS from the literature are 5.3–12.9 mg/kg/day, maximum 480 mg per day for 60 kg patient (Colomycin® injection‐European product) and 8–21.3 mg/kg/day, maximum 800 mg per day for 60 kg patient (Coly‐Mycin M® parenteral‐US product).The literature supports a CMS dose of 8 mg/kg/day divided every 8 hr (maximum 480 mg/day) for the treatment of APE secondary to Pseudomonas aeruginosa. The maximum recommended CMS dose of 480 mg/day is less than is recommended by the FDA‐approved and CFF dosing guidelines but in agreement with UK CF Trust Antibiotic Working Group recommendations. There is debate over the frequency of CMS administration (once daily vs. thrice‐daily) and its impact on resistance and clinical efficacy. Further study is needed to determine the tolerability and efficacy of extended‐interval dosing of CMS in the treatment of APE. Pediatr Pulmonol. 2013; 48:1–7. © 2012 Wiley Periodicals, Inc.

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Survival and Treatment for Colorectal Cancer Medicare Patients in Two Group/Staff Health Maintenance Organizations and the Fee-for-Service Setting

Cited by 42 publications

References 65 publications

Effects of health insurance and race on colorectal cancer treatments and outcomes

Effects of health insurance and race on colorectal cancer treatments and outcomes

Racial differences in tumor stage and survival for colorectal cancer in an insured population

Meta‐analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer

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