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早期乳腺癌治疗对不同残疾的年轻 Medicare 受益人的影响。

Early stage breast cancer treatments for younger Medicare beneficiaries with different disabilities.

机构信息

Institute for Health Policy, Division of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St., Rm 901C, Boston, MA 02114, USA.

出版信息

Health Serv Res. 2008 Oct;43(5 Pt 1):1752-67. doi: 10.1111/j.1475-6773.2008.00853.x. Epub 2008 May 12.

Abstract

OBJECTIVE

To explore how underlying disability affects treatments and outcomes of disabled women with breast cancer.

DATA SOURCES

Surveillance, Epidemiology, and End Results program data, linked with Medicare files and Social Security Administration disability group.

STUDY DESIGN

Ninety thousand two hundred and forty-three incident cases of early-stage breast cancer under age 65; adjusted relative risks and hazards ratios examined treatments and survival, respectively, for women in four disability groups compared with nondisabled women.

PRINCIPAL FINDINGS

Demographic characteristics, treatments, and survival varied among four disability groups. Compared with nondisabled women, those with mental disorders and neurological conditions had significantly lower adjusted rates of breast conserving surgery and radiation therapy. Survival outcomes also varied by disability type.

CONCLUSIONS

Compared with nondisabled women, certain subgroups of women with disabilities are especially likely to experience disparities in care for breast cancer.

摘要

目的

探讨潜在残疾如何影响患有乳腺癌的残疾女性的治疗和结局。

资料来源

监测、流行病学和最终结果计划数据,与医疗保险档案和社会保障管理局残疾组相关联。

研究设计

9243 例年龄在 65 岁以下的早期乳腺癌的发病病例;调整后的相对风险和危害比分别检查了四个残疾组的妇女与非残疾妇女相比的治疗和生存情况。

主要发现

四个残疾组的人口统计学特征、治疗和生存情况各不相同。与非残疾妇女相比,患有精神障碍和神经疾病的妇女接受保乳手术和放疗的调整后比率明显较低。生存结果也因残疾类型而异。

结论

与非残疾妇女相比,某些残疾女性亚组尤其可能在乳腺癌护理方面存在差异。

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本文引用的文献

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Treatment disparities for disabled medicare beneficiaries with stage I non-small cell lung cancer.
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