Division of Cancer Control and Population Sciences, Health Services and Economics Branch, National Cancer Institute, Rockville, MD 20850, USA.
Am J Prev Med. 2013 Sep;45(3):304-12. doi: 10.1016/j.amepre.2013.04.021.
Access to health care, particularly effective primary and secondary preventive care, is critical for cancer survivors, in order to minimize the adverse sequelae of cancer and its treatment.
The goal of the study was to evaluate the association between cancer survivorship and access to primary and preventive health care.
Cancer survivors (n=4960) and individuals without a cancer history (n=64,431) aged ≥ 18 years, from the 2008-2010 Medical Expenditure Panel Survey (MEPS), were evaluated. Multiple measures of access and preventive services use were compared. The association between cancer survivorship and access and preventive services was evaluated with multivariate logistic regression models, stratified by age group (18-64 years and ≥ 65 years), controlling for the effects of age, gender, race/ethnicity, education, marital status, and comorbidities. Data were analyzed in 2013.
Cancer survivors aged ≥ 65 years had equivalent or greater access and preventive services use than individuals without a cancer history, in adjusted analyses. However, among those aged 18-64 years with private health insurance, cancer survivors were more likely than other individuals to have a usual source of care and to use preventive services, whereas uninsured or publicly insured cancer survivors were generally less likely to have a usual source of care and to use preventive services than were uninsured or publicly insured adults without a cancer history.
Although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18-64 years suggest that improvements in survivor care are needed.
癌症幸存者需要获得医疗保健,特别是有效的初级和二级预防保健,以减轻癌症及其治疗的不良后果。
本研究旨在评估癌症生存与初级和预防保健的获取之间的关联。
对 2008-2010 年医疗支出面板调查(MEPS)中年龄≥18 岁的癌症幸存者(n=4960)和无癌症病史的个体(n=64431)进行评估。比较了多种获取和预防服务的使用情况。采用多变量逻辑回归模型,按年龄组(18-64 岁和≥65 岁)分层,控制年龄、性别、种族/民族、教育、婚姻状况和合并症的影响,评估癌症生存与获取和预防服务之间的关联。数据分析于 2013 年进行。
在调整分析中,≥65 岁的癌症幸存者的获取和预防服务的使用与无癌症病史的个体相当或更高。然而,在有私人医疗保险的 18-64 岁年龄组中,癌症幸存者比其他个体更有可能有常规医疗服务来源,并使用预防服务,而无保险或公共保险的癌症幸存者通常比无保险或公共保险的无癌症病史的成年人更不可能有常规医疗服务来源和使用预防服务。
尽管与其他个体相比,癌症幸存者的获取和预防保健的使用通常相当或更高,但对于 18-64 岁的无保险和公共保险的癌症幸存者,存在差异,表明需要改善幸存者的护理。