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    Receipt of general medical care by colorectal cancer patients: a longitudinal study

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    Authors
    Baldwin, Laura-Mae
    Dobie, Sharon A.
    Cai, Yong
    Saver, Barry G.
    Green, Pamela K.
    Wang, C. Y.
    UMass Chan Affiliations
    Department of Family Medicine and Community Health
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2011-01-07
    Keywords
    Aged
    Aged, 80 and over
    Colorectal Neoplasms
    Confidence Intervals
    Diabetes Mellitus
    Disease Management
    Early Detection of Cancer
    Female
    Humans
    Lipids
    Longitudinal Studies
    Male
    Mammography
    Preventive Health Services
    Primary Health Care
    Quality of Health Care
    Registries
    Risk
    Treatment Outcome
    United States
    Health Services Research
    Primary Care
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    Link to Full Text
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103392/pdf/nihms270164.pdf
    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. 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. 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). 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.
    Source
    J Am Board Fam Med. 2011 Jan-Feb;24(1):57-68. Link to article on publisher's site
    DOI
    10.3122/jabfm.2011.01.100080
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/36893
    PubMed ID
    21209345
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.3122/jabfm.2011.01.100080
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