Clauser Steven B, Arora Neeraj K, Bellizzi Keith M, Haffer Samuel C, Topor Marie, Hays Ron D
National Cancer Institute (NCI), Division of Cancer Control and Population Sciences, Bethesda, MD 20892-7344, USA.
Health Care Financ Rev. 2008 Summer;29(4):23-40.
Health plan member survey and cancer registry data were analyzed to understand differences in health-related quality of life (HRQOL) among cancer survivors and those without a cancer diagnosis enrolled in Medicare managed care. HRQOL was measured by the physical component summary score (PCS) and mental component summary score (MCS) of the Medical Outcomes Study SF-36, version 1.0. Cancer survivors enrolled in Medicare managed care have lower PCS and MCS scores than those enrollees who have never been diagnosed with cancer. PCS scores are worse than the MCS scores, and lowest for cancer survivors who are Hispanic, Medicaid enrollees, and those who have low income or education. HRQOL disparities are greatest among cancer survivors diagnosed with lung cancer and those with multiple primary cancer diagnoses. The influence of these variables persists when controlling for multiple variables including comorbidity status. Health plans should focus on addressing these disparities.
对健康计划成员调查和癌症登记数据进行了分析,以了解参加医疗保险管理式医疗的癌症幸存者与未被诊断出患有癌症的人群在健康相关生活质量(HRQOL)方面的差异。HRQOL通过医学结局研究简明健康调查问卷(SF-36)1.0版的身体成分汇总得分(PCS)和精神成分汇总得分(MCS)来衡量。参加医疗保险管理式医疗的癌症幸存者的PCS和MCS得分低于从未被诊断出患有癌症的参保者。PCS得分比MCS得分更差,对于西班牙裔癌症幸存者、医疗补助参保者以及低收入或低教育水平的癌症幸存者来说,PCS得分最低。在被诊断患有肺癌的癌症幸存者和患有多种原发性癌症诊断的幸存者中,HRQOL差距最大。在控制包括合并症状态在内的多个变量时,这些变量的影响依然存在。健康计划应专注于解决这些差异。