Download or read book The Impact of Rural Urban Residency on Colorectal Cancer Screening Stage at Diagnosis and Treatment in the Privately Insured Population written by Mesnad Alyabsi and published by . This book was released on 2018 with total page 163 pages. Available in PDF, EPUB and Kindle. Book excerpt: Colorectal Cancer (CRC) is the third most common and leading cause of cancer death in the United States. Although CRC screening can prevent and detect CRC at an early stage, about 35% of Americans are not screened. Despite the recent increase in screening, people with lower SES and those who live in rural areas have lowest screening. In rural areas, a common obstacle for screening is the long trips for health services which is associated with advanced CRC. Moreover, surgery is a substantial part of CRC treatment since stages I-III and some metastatic CRC (mCRC) patients are treated with surgery. Up to 25% of patients who undergo surgery get readmitted to the hospital due to several factors which costs $300 million annually. Prior studies showed some variations in CRC treatment between rural and urban patients. The purpose of this study was to assess the association between rural-urban status and CRC screening, stage at diagnosis and the receipt of CRC surgery. There were three specific aims: 1) To assess the impact of rurality on CRC screening, 2) To assess the impact of travel time on the stage of CRC diagnosis, and 3) To evaluate rural-urban differences in healthcare utilization. We conducted analyses using data from Blue Cross Blue Shield of Nebraska (BCBSNE) between 2012 and 2016. For Aim 1, the study population included BCBSNE members aged 50-64 years with average-risk CRC. For Aim2, the study population included BCBSNE members aged 50-64 years with average-risk CRC. For Aim 3, the study population consisted of CRC patients between the ages of 19-65 years old who had CRC surgery during the study period. Claims data were used to ascertain the CRC screening, diagnosis, receipt of surgery and hospital readmission using ICD and CPT codes. Rural-urban status was based on the Rural-Urban Commuting Area Codes and travel time between the residence and the provider facility was calculated using Google Map. For Aim 1, prevalence rates for FOBT and colonoscopy were calculated and compared using X2-test. Univariate and multivariate logistic regression analyses were performed to assess the relationship between the independent variables and CRC screening test. For Aim 2, we used Wilcoxon rank-sum tests for continuous variables and X2-tests for categorical variables and we adjusted for covariates using logistic regression. For Aim 3, Readmission and surgery status were estimated using multivariate logistic regression. There was no significant difference between rural and rural residents in colonoscopy use. However, after adjustment, rural residents were 47% more likely to use FOBT. Patients who do not use preventive services were 2.80 more likely to present with mCRC and urban residents were 3.50 times more likely to receive mCRC. The fact that 12% of our population presents with mCRC suggests some non-compliance with screening guidelines. Therefore, we recommend removing barriers that prevent rural patients from receiving screening colonoscopy and thus increase early detection of CRC. Until these obstacles have been lessened, screening with more convenient tests is encouraged. The use of mailed FOBT test is easy and more accessible.
Download or read book Colorectal Cancer written by Natalie Stewart and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Fulfilling the Potential of Cancer Prevention and Early Detection written by National Research Council and published by National Academies Press. This book was released on 2003-05-07 with total page 564 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
Download or read book Delivering Affordable Cancer Care in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2013-06-20 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rising health care costs are a central fiscal challenge confronting the United States. National spending on health care currently accounts for 18 percent of gross domestic product (GDP), but is anticipated to increase to 25 percent of GDP by 2037. The Bipartisan Policy Center argues that "this rapid growth in health expenditures creates an unsustainable burden on America's economy, with far-reaching consequences". These consequences include crowding out many national priorities, including investments in education, infrastructure, and research; stagnation of employee wages; and decreased international competitiveness.In spite of health care costs that far exceed those of other countries, health outcomes in the United States are not considerably better. With the goal of ensuring that patients have access to high-quality, affordable cancer care, the Institute of Medicine's (IOM's) National Cancer Policy Forum convened a public workshop, Delivering Affordable Cancer Care in the 21st Century, October 8-9, 2012, in Washington, DC. Delivering Affordable Cancer Care in the 21st Century summarizes the workshop.
Download or read book Access to Health Care in America written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
Download or read book Quality Through Collaboration written by Institute of Medicine and published by National Academies Press. This book was released on 2005-04-24 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.
Download or read book Cancer Survival in Africa Asia the Caribbean and Central America written by R. Sankaranarayanan and published by IARC Scientific Publications. This book was released on 2011 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Population-based cancer survival rates offer an important benchmark for measuring a health care system's overall effectiveness in the fight against cancer. While this type of information on high-resource countries is readily available, Cancer Survival in Africa, Asia, the Caribbean and Central America presents in-depth cancer survival data from 27 population-based cancer registries in 14 low- and middle-resource countries. The striking inequalities in cancer survival between countries and within countries described in this volume are largely related to the differences in general awareness, availability of early detection practices, trained human resources, diagnosis and treatment and the development and accessibility to cancer services, as well as, to a lesser extent, to issues of data quality and reliability. The differences in cancer survival reported in populations observed between and within countries studied in this volume provide valuable insights for future planning and investment by governments in primary prevention activities, early detection initiatives and tertiary care to achieve meaningful cancer control. The calendar period of registration of incident cases for the present study ranges between 1990 and 2001. Data on 564 606 cases of 1-56 cancer sites from different registries are reported. Data from eleven registries were utilized for eliciting survival trend and seventeen registries for reporting survival by clinical extent of disease. Besides chapters on every registry and general chapters on methodology, database and overview, the availability of online comparative statistics on cancer survival data by participating registries or cancer site in the form of tables or graphs is an added feature.
Download or read book Unequal Treatment written by Institute of Medicine and published by National Academies Press. This book was released on 2009-02-06 with total page 781 pages. Available in PDF, EPUB and Kindle. Book excerpt: Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Download or read book Identifying Typologies of Breast Cancer Patients Based on Multiple Individual and Contextual Factors for Timely Treatment Initiation written by Sharon Baik and published by . This book was released on 2018 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rationale: Breast cancer is the most commonly diagnosed cancer, excluding skin cancers, and is the second leading cause of cancer death among women in the United States. Despite advancements in screening, early detection, and cancer treatments, not all women have benefited equally. Racial and ethnic minorities, particularly African American women, and those of low income have higher breast cancer mortality rates compared to the general population. Previous research has identified a number of demographic (e.g., race/ethnicity, age, health insurance, income), medical (e.g., comorbidities with other illnesses, family medical history), environmental (e.g., geographic area), and health system (e.g., type of cancer-related services available) factors associated with breast cancer disparities. However, these factors have largely been examined individually, and no study has comprehensively evaluated how multiple individual and contextual factors impact breast cancer outcomes. Therefore, this dissertation project had two primary aims: 1) to identify distinct subgroups of breast cancer patients based on demographic, medical, environmental, and health system factors that have been shown to influence timeliness of breast cancer care, and 2) to examine differences among emergent classes in timely initiation of breast cancer treatment. Design: The proposed study used archival data from the control arm of the Patient Navigation Research Project (PNRP), a five-year 10-site clinical trial of adult patients from medically underserved populations with an abnormal cancer screening or a new diagnosis of breast, cervical, colorectal, or prostate cancer. For this study, the sample included 198 patients with newly diagnosed Stage I-III breast cancer who received usual standard of care (control arm) from four PNRP sites, and who received a treatment for breast cancer (e.g., surgery, chemotherapy, radiation, hormonal therapy). Control participants were primarily recruited via medical record abstraction for which informed consent was waived. Exploratory Latent Class Analysis (LCA) was used to identify subgroups of breast cancer patients based on demographic (race/ethnicity, age at diagnosis, health insurance status, annual household income), medical (comorbidities [Charlson Comorbidity Index], family history of cancer), environmental (geographic residence [urban vs. rural], and health system (cancer-related services available onsite) factors associated with timeliness of breast cancer care. For the second aim, the study conducted logistic regression analyses to examine if class membership significantly predicted timely breast cancer treatment initiation, defined as initiation of any treatment for breast cancer (e.g., surgery, chemotherapy, radiation, hormonal therapy) within 30 or 60 days of diagnosis, controlling for type of breast cancer treatment. Results: Three classes of breast cancer patients were identified with varying patterns of patient demographic, medical, and health system characteristics. The first class was distinguished by its high endorsement of indicators associated with timely breast cancer care; patients in this class were most likely to be White, have private health insurance, and have a family history of cancer. The second class was characterized by individual and contextual factors associated with treatment delays, including having public health insurance, not having a family history of cancer, and receiving care at a facility with the least amount of breast cancer services available onsite. The third class represented breast cancer patients with the oldest average age at diagnosis and the greatest number of medical comorbidities. Binomial logistic regression analyses demonstrated that the emergent classes did not significantly differ in the likelihood of initiating breast cancer treatment within 30 days or 60 days from breast cancer diagnosis, controlling for type of treatment. Conclusions: The present study used LCA to derive classes of breast cancer patients based on simultaneous evaluation of demographic, medical, environmental, and health system factors associated with timely breast cancer care. However, the emergent classes did not significantly differ in terms of timely initiation of breast cancer treatment following definitive diagnosis of breast cancer. The relatively small and homogenous study sample may have obscured differences in timeliness of breast cancer treatment initiation. Future studies should utilize LCA with larger, more diverse samples of breast cancer patients to identify distinct classes with unique combinations of individual and contextual characteristics that influence timeliness of breast cancer care. Identification of distinct typologies of breast cancer patients provides a deeper understanding of how the combination of factors synergistically impacts breast cancer outcomes and can help target interventions to specific subgroups of patients that are most likely to experience delays in breast cancer care.
Download or read book Understanding Racial and Ethnic Differences in Health in Late Life written by National Research Council and published by National Academies Press. This book was released on 2004-09-08 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.
Download or read book Tele oncology written by Giovanna Gatti and published by Springer. This book was released on 2015-06-09 with total page 91 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explains how telemedicine can offer solutions capable of improving the care and survival rates of cancer patients and can also help patients to live a normal life in spite of their condition. Different fields of application – community, hospital and home based – are examined, and detailed attention is paid to the use of tele-oncology in rural/extreme rural settings and in developing countries. The impact of new technologies and the opportunities afforded by the social web are both discussed. The concluding chapters consider eLearning in relation to cancer care and assess the scope for education to improve prevention. No medical condition can shatter people’s lives as cancer does today and the need to develop strategies to reduce the disease burden and improve quality of life is paramount. Readers will find this new volume in Springer’s TELe Health series to be a rich source of information on the important contribution that can be made by telemedicine in achieving these goals.
Download or read book The Future of the Public s Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Download or read book Insuring America s Health written by Institute of Medicine and published by National Academies Press. This book was released on 2004-02-14 with total page 225 pages. Available in PDF, EPUB and Kindle. Book excerpt: According to the Census Bureau, in 2003 more than 43 million Americans lacked health insurance. Being uninsured is associated with a range of adverse health, social, and economic consequences for individuals and their families, for the health care systems in their communities, and for the nation as a whole. This report is the sixth and final report in a series by the Committee on the Consequences of Uninsurance, intended to synthesize what is known about these consequences and communicate the extent and urgency of the issue to the public. Insuring America's Health recommends principles related to universality, continuity of coverage, affordability to individuals and society, and quality of care to guide health insurance reform. These principles are based on the evidence reviewed in the committee's previous five reports and on new analyses of past and present federal, state, and local efforts to reduce uninsurance. The report also demonstrates how those principles can be used to assess policy options. The committee does not recommend a specific coverage strategy. Rather, it shows how various approaches could extend coverage and achieve certain of the committee's principles.
Download or read book Establishing Effective Patient Navigation Programs in Oncology written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-08-13 with total page 115 pages. Available in PDF, EPUB and Kindle. Book excerpt: Delivering high-quality cancer care to all patients presents numerous challenges, including difficulties with care coordination and access. Patient navigation is a community-based service delivery intervention designed to promote access to timely diagnosis and treatment of cancer and other chronic diseases by eliminating barriers to care, and has often been proposed and implemented to address these challenges. However, unresolved questions include where patient navigation programs should be deployed, and which patients should be prioritized to receive navigation services when resources are limited. To address these issues and facilitate discussion on how to improve navigation services for patients with cancer, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop on November 13 and 14, 2017. At this workshop, a broad range of experts and stakeholders, including clinicians, navigators, researchers, and patients, explored which patients need navigation and who should serve as navigators, and the benefits of navigation and current gaps in the evidence base.
Download or read book The Unequal Burden of Cancer written by Institute of Medicine and published by National Academies Press. This book was released on 1999-06-11 with total page 353 pages. Available in PDF, EPUB and Kindle. Book excerpt: We know more about cancer prevention, detection, and treatment than ever beforeâ€"yet not all segments of the U.S. population have benefited to the fullest extent possible from these advances. Some ethnic minorities experience more cancer than the majority population, and poor peopleâ€"no matter what their ethnicityâ€"often lack access to adequate cancer care. This book provides an authoritative view of cancer as it is experienced by ethnic minorities and the medically underserved. It offers conclusions and recommendations in these areas: Defining and understanding special populations, and improving the collection of cancer-related data. Setting appropriate priorities for and increasing the effectiveness of specific National Institutes of Health (NIH) research programs, to ensure that special populations are represented in clinical trials. Disseminating research results to health professionals serving these populations, with sensitivity to the issues of cancer survivorship. The book provides background data on the nation's struggle against cancer, activities and expenditures of the NIH, and other relevant topics.
Download or read book Health at a Glance 2021 OECD Indicators written by OECD and published by OECD Publishing. This book was released on 2021-11-09 with total page 275 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health at a Glance provides a comprehensive set of indicators on population health and health system performance across OECD members and key emerging economies. This edition has a special focus on the health impact of COVID-19 in OECD countries, including deaths and illness caused by the virus, adverse effects on access and quality of care, and the growing burden of mental ill-health.
Download or read book Clinical Case Studies for the Family Nurse Practitioner written by Leslie Neal-Boylan and published by John Wiley & Sons. This book was released on 2011-11-28 with total page 432 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical Case Studies for the Family Nurse Practitioner is a key resource for advanced practice nurses and graduate students seeking to test their skills in assessing, diagnosing, and managing cases in family and primary care. Composed of more than 70 cases ranging from common to unique, the book compiles years of experience from experts in the field. It is organized chronologically, presenting cases from neonatal to geriatric care in a standard approach built on the SOAP format. This includes differential diagnosis and a series of critical thinking questions ideal for self-assessment or classroom use.
