A Elixhauser — Page 3 | Search PubMed

PubMedDate not supplied

Health-related quality of life evaluations of gastric and pancreatic cancer.

This review addresses the state of the literature on health-related quality of life (HRQL) assessment among patients with cancers of the pancreas and stomach. We first briefly review the epidemiology of these cancers. We examine the concept of HRQL and the degree to which it has been measured among these patient groups. The impact of gastric and pancreatic cancers on HRQL is described, including the domains which these conditions are most likely to impact. The effect of different treatments on HRQL is considered, including surgical procedures, pharmacological and non-pharmacological therapies, and procedures for symptom palliation. Based on our findings on the limited quantity and quality of the body of literature, we make suggestions for further research in the area. Results suggest three areas in which HRQL can play an important role in the study of gastric and pancreatic cancer. First, future investigations should consider both survival and HRQL in comparing surgical procedures. Second, studies of chemotherapy should include HRQL evaluation, with careful attention to conducting assessments at times appropriate to capture the effects of chemotherapy. Third, studies of the impact of palliative care should include assessments of HRQL.

Humans↗

PubMedDate not supplied

Racial and gender differences in use of procedures for black and white hospitalized adults.

A number of studies have found that blacks and females with coronary heart disease are less likely to undergo major diagnostic and therapeutic procedures than whites and males, even after controlling for severity of illness and other indicators of physical condition. This investigation examined 78 conditions treated in acute care hospitals to identify possible variations in medical treatment by race and gender among blacks and whites. The study is unique in examining such a wide range of conditions and in using an all-payer national sample. The study examines over 1.7 million inpatient discharge abstracts from the Hospital Cost and Utilization Project, a national sample of about 500 hospitals in the United States. Logistic regression modeling was used to describe the influence of race and gender among blacks and whites on the likelihood of having a major therapeutic or major diagnostic procedure, controlling for patient age, disease severity, health insurance and hospital-level characteristics. The study found that blacks were less likely than whites to receive major therapeutic procedures in 37 of 77 (48%) conditions, and females were less likely than males to receive major therapeutic procedures for 32 of 62 (52%) conditions. The proportion of conditions in which blacks and females were less likely to receive a major diagnostic procedure (without a major therapeutic procedure) was 21% and 26%, respectively. This study identified a number of conditions with apparent variations in medical treatment by race or gender among blacks and whites that should be targeted for more detailed investigations.

Adult↗