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  1. Access to bone marrow transplantation for leukemia and lymphoma : The role of sociodemographic factors.

    Article - En anglais

    Purpose 

    Use of bone marrow transplantation (BMT), a complex, costly treatment for many forms of cancers, has increased significantly in recent years.

    The increasingly competitive health care marketplace raises concerns about patient access to costly medical procedures such as BMT.

    We attempted to evaluate patient access to BMT for the treatment of leukemias and lymphomas.

    Methods 

    We analyzed inpatient hospital discharge data rom four states (California, Maryland, Massachusetts, and New York) for 2 years (1988 and 1991) to examine whether the use of BMT for patients with either leukemia or lymphoma varies by sociodemographic characteristics and insurance coverage.

    We developed a sorting algorithm to collapse the discharge data into patient level records.

    We used logistic regression to analyze the odds of receiving a BMT stratified by disease type (leukemia or lymphoma).

    Results 

    After controlling for other factors, black patients with leukemia are 51% to 53% as likely as whites, while black patients with lymphoma are 34% to 45% as likely as white patients to undergo a BMT (P<. 05).

    Medicaid, self-pay patients, and Health Maintenance Organization (HMO) enrollees with either leukemia or lymphoma are significantly less likely to undergo a BMT compared with patients with private insurance.

    Younger patients are significantly more predisposed to undergo a BMT than older patients. (...)

    Mots-clés Pascal : Leucémie, Homme, Transplantation, Lymphome, Moelle osseuse, Etats Unis, Amérique du Nord, Amérique, Coût, Assurance maladie, Epidémiologie, Hémopathie maligne, Lymphoprolifératif syndrome

    Mots-clés Pascal anglais : Leukemia, Human, Transplantation, Lymphoma, Bone marrow, United States, North America, America, Costs, Health insurance, Epidemiology, Malignant hemopathy, Lymphoproliferative syndrome

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0384944

    Code Inist : 002B27D02. Création : 12/09/1997.