The current study compares treatment use and long-term survival in colorectal cancer patients between Medicare beneficiaries enrolled in two large prepaid group/staff health maintenance organizations (HMOs) and the fee-for-service (FFS) setting.
The study is based on 15,352 colorectal cancer cases diagnosed between 1985 and 1992 and followed through 1995.
Survival differences between the HMO and FFS cases were assessed using Cox regression.
Treatment differences were evaluated using logistic regression.
HMO cases had a lower overall mortality than did FFS cases but not a significantly lower colorectal cancer-specific mortality.
Use of surgical resection was similar between HMO and FFS cases.
However, rectal cancer cases in the HMOs were more likely to receive postsurgical radiation therapy than FFS cases.
Superior overall surival in the HMOs may be the result of increased colorectal cancer screening, greater use of adjuvant therapies, and selection of healthier individuals.
Mots-clés Pascal : Tumeur maligne, Côlon, Rectum, Traitement, Survie, Etude comparative, Organisation santé, Homme, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Rectum pathologie, Medicare, Health maintenance organization
Mots-clés Pascal anglais : Malignant tumor, Colon, Rectum, Treatment, Survival, Comparative study, Public health organization, Human, Digestive diseases, Intestinal disease, Colonic disease, Rectal disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0423298
Code Inist : 002B13B01. Création : 22/03/2000.