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Longitudinal Patterns in Survival, Comorbidity, Healthcare Utilization and Quality of Care among Older Women Following Breast Cancer Diagnosis

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An Erratum to this article was published on 01 September 2010

Abstract

OBJECTIVES

To compare longitudinal patterns of health care utilization and quality of care for other health conditions between breast cancer-surviving older women and a matched cohort without breast cancer.

DESIGN

Prospective five-year longitudinal comparison of cases and matched controls.

SUBJECTS

Newly identified breast cancer patients recruited during 1997–1999 from four geographic regions (Los Angeles, CA; Minnesota; North Carolina; and Rhode Island; N = 422) were matched by age, race, baseline comorbidity and zip code location with up to four non-breast-cancer controls (N = 1,656).

OUTCOMES

Survival; numbers of hospitalized days and physician visits; total inpatient and outpatient Medicare payments; guideline monitoring for patients with cardiovascular disease and diabetes, and bone density testing and colorectal cancer screening.

RESULTS

Five-year survival was similar for cases and controls (80% and 82%, respectively; p = 0.18). In the first follow-up year, comorbidity burden and health care utilization were higher for cases (p < 0.01), with most differences diminishing over time. However, the number of physician visits was higher for cases (p < 0.01) in every year, driven partly by more cancer and surgical specialist visits. Cases and controls adhered similarly to recommended bone density testing, and monitoring of cardiovascular disease and diabetes; adherence to recommended colorectal cancer screening was better among cases.

CONCLUSION

Breast cancer survivors’ health care utilization and disease burden return to pre-diagnosis levels after one year, yet their greater use of outpatient care persists at least five years. Quality of care for other chronic health problems is similar for cases and controls.

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Acknowledgements

This work was supported by grants CA106979, CA/AG 70818, CA84506, and CA92395 from the National Cancer Institute.

Conflict of Interest

None disclosed.

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Authors and Affiliations

  1. Center for Organization, Leadership and Management Research (COLMR), VA Boston Healthcare System, Boston, MA, USA

    Amresh D. Hanchate PhD

  2. Health Care Research Unit, Section of General Internal Medicine, Boston University School of Medicine, 801, Massachusetts Ave #2077, Boston, MA, 01532, USA

    Amresh D. Hanchate PhD & Arlene S. Ash PhD

  3. Section of Geriatrics, Boston University School of Medicine, Boston, MA, USA

    Kerri M. Clough-Gorr DSc, MPH, Soe Soe Thwin PhD & Rebecca A. Silliman MD, PhD

  4. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    Kerri M. Clough-Gorr DSc, MPH & Rebecca A. Silliman MD, PhD

  5. National Institute for Cancer Epidemiology and Registration (NICER) Institute of Social and Preventative Medicine (ISPM), University of Zurich, Zurich, Switzerland

    Kerri M. Clough-Gorr DSc, MPH

  6. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA

    Arlene S. Ash PhD

  7. Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Healthcare System, Boston, MA, USA

    Soe Soe Thwin PhD

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  1. Amresh D. Hanchate PhD
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  2. Kerri M. Clough-Gorr DSc, MPH
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  5. Rebecca A. Silliman MD, PhD
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Correspondence to Amresh D. Hanchate PhD.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s11606-010-1493-8

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Hanchate, A.D., Clough-Gorr, K.M., Ash, A.S. et al. Longitudinal Patterns in Survival, Comorbidity, Healthcare Utilization and Quality of Care among Older Women Following Breast Cancer Diagnosis. J GEN INTERN MED 25, 1045–1050 (2010). https://doi.org/10.1007/s11606-010-1407-9

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  • DOI: https://doi.org/10.1007/s11606-010-1407-9

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