National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Cancer (10)
- Cancer: Prostate Cancer (2)
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- Diagnostic Safety and Quality (1)
- Elderly (6)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 10 of 10 Research Studies DisplayedModi PK, Kaufman SR, Qi J
National trends in active surveillance for prostate cancer: validation of medicare claims-based algorithms.
This study analyzed the use of active surveillance of low-risk prostate cancer among a wide variety of health care practices. Researchers identified men with prostate cancer from 2012-2014 using a 100% sample of Michigan Medicare data and linked them with the Michigan Urologic Surgery Improvement Collaborative (MUSIC) registry. They analyzed the performance of 8 claims-based algorithms that were used and selected 3 of them to apply to a 20% national Medicare sample. The 3 algorithms were determined to be either the most sensitive, the most specific, and a balanced algorithm incorporating age and comorbidity. They found that use of surveillance for men increased from 2007 to 2014 but there was a large decrease in the rate of prostate cancer diagnosis. The rate of active surveillance either increased or remained stable depending on the algorithm used.
AHRQ-funded; HS025707.
Citation: Modi PK, Kaufman SR, Qi J .
National trends in active surveillance for prostate cancer: validation of medicare claims-based algorithms.
Urology 2018 Oct;120:96-102. doi: 10.1016/j.urology.2018.06.037..
Keywords: Cancer, Cancer: Prostate Cancer, Medicare, Men's Health, Payment
Mian HS, Wildes TM, Fiala MA
Development of a Medicare health outcomes survey deficit-accumulation frailty index and its application to older patients with newly diagnosed multiple myeloma.
JCO Clinical Cancer Informatics 2018; 2):1-13. doi: 10.1200/cci.18.00043.
This study’s objective was to develop a frailty index for older patients and apply it to a subset of patients newly diagnosed with multiple myeloma. The study used the Rockwood Accumulation of Deficits approach for the Medicare Health Outcomes Study (MHOS). Data from over 2 million patients without cancer older than 66 years of age from SEER-MHOS linked databases were compared to the cohort with multiple myeloma. It was found that among patients without cancer, each 10% increase in the frailty index was associated with a 40% increased risk of death. For the multiple myeloma cohort, each 10% increase in the frailty index was associated with a 16% increased risk for death. Median time for overall survival was only 26.8 months for patients considered frail, compared with 43.7 months for those who were not. This frailty index could be used a predictor of overall survival in older multiple myeloma patients.
This study’s objective was to develop a frailty index for older patients and apply it to a subset of patients newly diagnosed with multiple myeloma. The study used the Rockwood Accumulation of Deficits approach for the Medicare Health Outcomes Study (MHOS). Data from over 2 million patients without cancer older than 66 years of age from SEER-MHOS linked databases were compared to the cohort with multiple myeloma. It was found that among patients without cancer, each 10% increase in the frailty index was associated with a 40% increased risk of death. For the multiple myeloma cohort, each 10% increase in the frailty index was associated with a 16% increased risk for death. Median time for overall survival was only 26.8 months for patients considered frail, compared with 43.7 months for those who were not. This frailty index could be used a predictor of overall survival in older multiple myeloma patients.
AHRQ-funded; HS019455.
Citation: Mian HS, Wildes TM, Fiala MA .
Development of a Medicare health outcomes survey deficit-accumulation frailty index and its application to older patients with newly diagnosed multiple myeloma.
JCO Clin Cancer Inform 2018;2. doi: 10.1200/cci.18.00043..
Keywords: Cancer, Diagnostic Safety and Quality, Elderly, Health Status, Medicare
Mehta HB, Sura SD, Adhikari D
Adapting the Elixhauser comorbidity index for cancer patients.
This study was designed to adapt the Elixhauser comorbidity index for 4 cancer-specific populations and compare 3 versions of the Elixhauser comorbidity score with 3 versions of the Charlson comorbidity score for predicting 2-year survival with 4 types of cancer. Using data from the Texas Cancer Registry-linked Medicare data from 2005 to 2011, the researchers found that cancer-specific Elixhauser comorbidity scores performed slightly better than cancer-specific Charlson comorbidity scores. Individual Elixhauser comorbidities performed best.
AHRQ-funded; HS022134.
Citation: Mehta HB, Sura SD, Adhikari D .
Adapting the Elixhauser comorbidity index for cancer patients.
Cancer 2018 May 1;124(9):2018-25. doi: 10.1002/cncr.31269.
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Keywords: Cancer, Elderly, Medicare, Patient-Centered Outcomes Research, Registries
Olszewski AJ, Zullo AR, Nering CR
Use of charity financial assistance for novel oral anticancer agents.
Novel oral targeted drugs are increasingly used for cancer therapy, but their extreme cost, often exceeding $10,000 per month, poses a significant barrier for patients and insurers alike. The findings findings of this study indicate that high out-of-pocket burden for expensive novel oral anticancer drugs leads to widespread use of charity support in the United States and that a significant financial barrier disparately affects older Medicare beneficiaries.
AHRQ-funded; HS022998.
Citation: Olszewski AJ, Zullo AR, Nering CR .
Use of charity financial assistance for novel oral anticancer agents.
J Oncol Pract 2018 Apr;14(4):e221-e28. doi: 10.1200/jop.2017.027896.
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Keywords: Cancer, Elderly, Healthcare Costs, Medicare, Medication
Raval AD, Madhavan S, Mattes MD
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
The current retrospective observational study was conducted to examine the association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer. It found that those with none of the 3 types of chronic conditions (cardiometabolic, mental health, and respiratory) were 44 percent more likely to be diagnosed with advanced prostate cancer compared to men with all 3 types of chronic conditions.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
Popul Health Manag 2016 Dec;19(6):445-53. doi: 10.1089/pop.2015.0141.
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Keywords: Cancer, Cancer: Prostate Cancer, Elderly, Medicare
Wang SY, Hall J, Pollack CE
Associations between end-of-life cancer care patterns and Medicare expenditures.
The authors examined the extent to which patterns of intensive end-of-life care explain geographic variation in end-of-life care expenditures among cancer decedents. The mean expenditure per cancer decedent in the last month of life was $10,800, with considerable variation in the percentage of decedents receiving intensive end-of-life care intervention. Regional patterns of late chemotherapy or late hospice use explained only approximately 1% of the expenditure difference, while the proportion of decedents who had ICU admissions within 30 days of death was a major driver of variation, explaining 37.6% of the expenditure difference. They concluded that promoting appropriate end-of-life care has the potential to reduce geographic variation in end-of-life care expenditures.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Associations between end-of-life cancer care patterns and Medicare expenditures.
J Natl Compr Canc Netw 2016 Aug;14(8):1001-8.
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Keywords: Cancer, Elderly, Healthcare Costs, Medicare, Palliative Care
Kim EH, Vetter JM, Kuxhausen AN
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
The researchers evaluated the utilization of follow-up imaging after nephrectomy for renal cell carcinoma (RCC) in nationally representative data. Using Surveillance, Epidemiology, End Results (SEER) data, they found that, in the Medicare population, surveillance imaging is performed in a limited number of patients following nephrectomy for RCC but that increasing tumor stage is predictive of both increased chest and abdominal imaging surveillance.
AHRQ-funded; HS019455.
Citation: Kim EH, Vetter JM, Kuxhausen AN .
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
Urol Oncol 2016 May;34(5):237.e11-8. doi: 10.1016/j.urolonc.2015.11.017.
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Keywords: Cancer, Healthcare Utilization, Imaging, Medicare
Wang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns
Rocke DJ, Beumer HW, Taylor DH, Jr.
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
The investigators sought to determine how baseline attitudes toward quality vs quantity of life affect end-of-life resource allocation. They found that, compared with patients and caregivers, otolaryngology-head and neck surgery (OHNS) physician allocations differed significantly in all 15 benefit categories except home care. They concluded that understanding the effect of baseline attitudes is important for effective end-of-life discussions.
AHRQ-funded; HS018360.
Citation: Rocke DJ, Beumer HW, Taylor DH, Jr. .
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
JAMA Otolaryngol Head Neck Surg 2014 Jun;140(6):497-503. doi: 10.1001/jamaoto.2014.494.
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Keywords: Cancer, Caregiving, Medicare, Palliative Care, Provider: Physician, Quality of Life
Erten MZ, Davidoff AJ, Zuckerman IH
AHRQ Author: Davidoff AJ
The effect of supplemental medical and prescription drug coverage on health care spending for Medicare beneficiaries with cancer.
The researchers examined whether patients with newly diagnosed cancer respond differently to supplemental coverage than the general Medicare population. They concluded that Medicare beneficiaries with cancer are less responsive to the presence and type of supplemental insurance than are beneficiaries without cancer. They recommended that policymakers consider welfare effects associated with coverage restrictions.
AHRQ-authored.
Citation: Erten MZ, Davidoff AJ, Zuckerman IH .
The effect of supplemental medical and prescription drug coverage on health care spending for Medicare beneficiaries with cancer.
Value Health 2014 Jan-Feb;17(1):15-21. doi: 10.1016/j.jval.2013.11.003.
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Keywords: Cancer, Health Insurance, Medicare, Medication