The continuum of breast cancer care and outcomes in the U.S. Military Health System: an analysis by benefit type and care source.

Purpose: This study investigates transition rates between breast cancer diagnosis, recurrence, and death by insurance benefit type and care source in U.S. Military Health System (MHS).Methods: The MHS data repository and central cancer registry linked data were used to identify women aged 40-64 with...

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Publicado en:Journal of Cancer Survivorship Vol. 12; no. 3; pp. 407 - 417
Autores principales: Eaglehouse, Yvonne L., Shao, Stephanie, Chan, Wenyaw, Brown, Derek, Manjelievskaia, Janna, Shriver, Craig D., Zhu, Kangmin
Formato: research Journal Article
Publicado: Springer Nature Jun2018
Acceso en línea:Ver este registro en EBSCOhost
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        19322259
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      dt: Jun2018
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s11764-018-0680-1
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        atl: The continuum of breast cancer care and outcomes in the U.S. Military Health System: an analysis by benefit type and care source.
      aug:
        au:
          Eaglehouse, Yvonne L.
          Shao, Stephanie
          Chan, Wenyaw
          Brown, Derek
          Manjelievskaia, Janna
          Shriver, Craig D.
          Zhu, Kangmin
        affil: John P. Murtha Cancer Center, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, 11300 Rockville Pike, Suite 1120, 20852, Rockville, MD, USA
      sug:
        subj:
          Continuity of Patient Care Administration
          Continuity of Patient Care Standards
          After Care Standards
          After Care Methods
          Breast Neoplasms Rehabilitation
          After Care
          Military Personnel
          Female
          Human
          Prospective Studies
          Health Systems Agencies Administration
          Breast Neoplasms Epidemiology
          Neoplasm Recurrence, Local
          Middle Age
          United States
          Adult
          Insurance Benefits Standards
          Treatment Outcomes
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Scales
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Female
      ab: Purpose: This study investigates transition rates between breast cancer diagnosis, recurrence, and death by insurance benefit type and care source in U.S. Military Health System (MHS).Methods: The MHS data repository and central cancer registry linked data were used to identify women aged 40-64 with histologically confirmed breast cancer between 2003 and 2007. Three-state continuous time Markov models were used to estimate transition rates and transition rate ratios (TRRs) by TRICARE benefit type (Prime or non-Prime) and care source (direct, purchased, or both), adjusted for demographic, tumor, and treatment variables.Results: Analyses included 2668 women with transitions from diagnosis to recurrence (n = 832), recurrence to death (n = 79), and diagnosis to death without recurrence (n = 91). Compared to women with Prime within each care source, women with non-Prime using both care sources had higher transition rates (TRR 1.47, 95% CI 1.03, 2.10). Compared to those using direct care within each benefit type, women utilizing both care sources with non-Prime had higher transition rates (TRR 1.86, 95% CI 1.11, 3.13), while women with Prime utilizing purchased care had lower transition rates (TRR 0.82, 95% CI 0.68, 0.98).Conclusions: In the MHS, women with non-Prime benefit plans compared to Prime had higher transition rates along the breast cancer continuum among both care source users. Purchased care users had lower transition rates than direct care users among Prime beneficiaries.Implications For Cancer Survivors: Benefit plan and care source may be associated with breast cancer progression. Further research is needed to demonstrate differences in survivorship.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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