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Grant Details

Grant Number: 1R01CA100029-01 Interpret this number
Primary Investigator: Iezzoni, Lisa
Organization: Beth Israel Deaconess Medical Center
Project Title: Cancer Care and Outcomes for Disabled Medicare Patients
Fiscal Year: 2003


Abstract

DESCRIPTION (provided by applicant): Information from the Surveillance, Epidemiology, and End Results (SEER) Program merged with Medicare claims offers important insights into patterns of health care services, costs, and outcomes for Medicare beneficiaries with cancer. These findings have virtually exclusively pertained to Medicare recipient age 65 and older. However, Medicare covers more than 5 million disabled persons under age 65, with annual total costs exceeding $20 billion, and millions more, now over age 65, initially received Medicare because of disability. Despite these large numbers and high costs, disabled Medicare beneficiaries who develop cancer have received little attention. The primary purpose of the proposed project is to describe cancer diagnoses, initial treatments, palliative care, longevity, and costs to Medicare among older and younger Medicare beneficiaries with disabilities. Secondary goals are to compare cancer diagnoses, interventions, and clinical and cost outcomes between persons with and without disabilities. The project will examine four high-frequency diseases (lung, breast, colorectal, and prostate cancers), and it will use merged SEER-Medicare data from cases diagnosed from 1986 through 1999. Using diagnosis, stage, and treatment information from SEER and diagnosis and procedure codes and payment information from Medicare claims, this study will address questions across the continuum of care, from diagnosis to end of life. Questions include: whether persons with disabilities are diagnosed at later stages than non-disabled persons; whether initial treatments differ; whether all-cause and cancer-specific mortality rates differ; whether use of home care and hospice services differ; whether insurance type matters (fee-for-service versus managed care); and additional costs to Medicare when disabled beneficiaries develop cancer. This study will provide the first comprehensive information on cancer detection, care, costs, and outcomes among disabled Medicare beneficiaries. These findings may suggest areas where more attention is needed, such as increasing cancer screening among disabled Medicare recipients or rethinking initial treatment strategies.



Publications

Early stage breast cancer treatments for younger Medicare beneficiaries with different disabilities.
Authors: Iezzoni L.I. , Ngo L.H. , Li D. , Roetzheim R.G. , Drews R.E. , McCarthy E.P. .
Source: Health services research, 2008 Oct; 43(5 Pt 1), p. 1752-67.
EPub date: 2008-05-12.
PMID: 18479411
Related Citations

Cancer incidence in elderly Medicare and dually eligible beneficiaries.
Authors: Bradley C.J. , Luo Z. , Given C.W. .
Source: Health services research, 2008 Oct; 43(5 Pt 1), p. 1768-79.
EPub date: 2008-05-12.
PMID: 18479409
Related Citations

Managed care and cancer outcomes for Medicare beneficiaries with disabilities.
Authors: Roetzheim R.G. , Chirikos T.N. , Wells K.J. , McCarthy E.P. , Ngo L.H. , Li D. , Drews R.E. , Iezzoni L.I. .
Source: The American journal of managed care, 2008 May; 14(5), p. 287-96.
PMID: 18471033
Related Citations

Cost disparities in lung cancer treatment by disability status, sex, and race.
Authors: Chirikos T.N. , Roetzheim R.G. , McCarthy E.P. , Iezzoni L.I. .
Source: Disability and health journal, 2008 Apr; 1(2), p. 108-15.
PMID: 19881893
Related Citations

Treatment disparities for disabled medicare beneficiaries with stage I non-small cell lung cancer.
Authors: Iezzoni L.I. , Ngo L.H. , Li D. , Roetzheim R.G. , Drews R.E. , McCarthy E.P. .
Source: Archives of physical medicine and rehabilitation, 2008 Apr; 89(4), p. 595-601.
PMID: 18373987
Related Citations

Cancer stage at diagnosis and survival among persons with Social Security Disability Insurance on Medicare.
Authors: McCarthy E.P. , Ngo L.H. , Chirikos T.N. , Roetzheim R.G. , Li D. , Drews R.E. , Iezzoni L.I. .
Source: Health services research, 2007 Apr; 42(2), p. 611-28.
PMID: 17362209
Related Citations

Disparities in breast cancer treatment and survival for women with disabilities.
Authors: McCarthy E.P. , Ngo L.H. , Roetzheim R.G. , Chirikos T.N. , Li D. , Drews R.E. , Iezzoni L.I. .
Source: Annals of internal medicine, 2006-11-07; 145(9), p. 637-45.
PMID: 17088576
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