You are here

Taylor Jr., Donald H.

Positions:

Professor in the Sanford School of Public Policy

Sanford School of Public Policy
Sanford School of Public Policy

Professor of Business Administration

Fuqua School of Business
Fuqua School of Business

Assistant Professor of Community and Family Medicine

Community and Family Medicine
School of Medicine

Associate Professor in the School of Nursing

School of Nursing
School of Nursing

Affiliate, Duke Global Health Institute

Duke Global Health Institute
Institutes and Provost's Academic Units

Affiliate of the Duke Initiative for Science & Society

Duke Science & Society
Institutes and Provost's Academic Units

Member of the Duke Clinical Research Institute

Duke Clinical Research Institute
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 1990

B.S. — University of North Carolina at Chapel Hill

M.P.P. 1992

M.P.P. — University of North Carolina at Chapel Hill

Ph.D. 1995

Ph.D. — University of North Carolina at Chapel Hill

News:

Don Taylor Podcast on Health Care Help for Aging Seniors

December 10, 2015 — Duke Campaign Stop 2016

Don Taylor: Can palliative care save money?

August 20, 2015 — Marketplace

What Do Seniors Want When They're Dying?

December 17, 2015 — Sanford School Ways & Means Podcast

Grants:

Which palliative care quality measures improve patient-centered outcomes?

Administered By
Duke Cancer Institute
AwardedBy
Agency for Healthcare Research and Quality
Role
Mentor
Start Date
September 30, 2015
End Date
September 29, 2020

Implementing Best Practice in Palliative Care

Administered By
Center for the Study of Aging and Human Development
AwardedBy
Agency for Healthcare Research and Quality
Role
Co Investigator
Start Date
September 30, 2013
End Date
September 29, 2018

Supporting Medicaid Reform in North Carolina

Administered By
Social Science Research Institute
AwardedBy
A. J. Fletcher Foundation
Role
Advisor
Start Date
June 22, 2017
End Date
July 30, 2018

Caregivers' Reactions and Experience: Imaging Dementia - Evidence for Amyloid Scanning - CARE IDEAS

Administered By
Basic Science Departments
AwardedBy
Brown University
Role
Co Investigator
Start Date
September 01, 2016
End Date
April 30, 2018

Timely Guidance on Payment and Coverage Reform

Administered By
Social Science Research Institute
AwardedBy
Robert Wood Johnson Foundation
Role
Principal Investigator
Start Date
April 01, 2017
End Date
March 31, 2018

Increasing Patient and System Value with Community Based Palliative Care

Administered By
Duke Clinical Research Institute
AwardedBy
Four Seasons
Role
Principal Investigator
Start Date
September 01, 2014
End Date
November 30, 2017

Palliative Care in Heart Failure (PAL-HF)

Administered By
Duke Clinical Research Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 27, 2011
End Date
July 31, 2016

Increasing Patient and System Value with Community Based Palliative Care

Administered By
Duke Clinical Research Institute
AwardedBy
Four Seasons
Role
Principal Investigator
Start Date
September 01, 2014
End Date
August 31, 2015

Hospice to Palliative Care: Maximizing Patient Preference and Cost Savings

Administered By
Center for Health Policy & Inequalities Research
AwardedBy
Agency for Healthcare Research and Quality
Role
Principal Investigator
Start Date
September 30, 2009
End Date
July 31, 2014

Creation and demonstration of a palliative care research cooperative group

Administered By
Duke Clinical Research Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 30, 2010
End Date
September 29, 2013

Organizational Variability and Racial Disparities in Hospice Use

Administered By
Center for the Study of Aging and Human Development
AwardedBy
National Institutes of Health
Role
Advisor
Start Date
September 01, 2007
End Date
May 31, 2013

Until Death Do Us Part: Careers of Caregiving Wives

Administered By
Trinity College of Arts & Sciences
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 01, 2004
End Date
August 31, 2008

APOE, Quality of Life and Medical Costs in Late Life

Administered By
Center for the Study of Aging and Human Development
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
May 01, 2000
End Date
April 30, 2004

Perception of Risk and Behavior in the Elderly

Administered By
Trinity College of Arts & Sciences
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 15, 1999
End Date
August 30, 2003

Determinants and Cost of Alcohol Abuse Among Elderly

Administered By
Trinity College of Arts & Sciences
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
May 01, 1999
End Date
December 31, 2002

Linking Probate Data to an Elderly Cohort

Administered By
Trinity College of Arts & Sciences
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 30, 1998
End Date
September 29, 2000
Show More

Publications:

Delivery of Community-Based Palliative Care: Findings from a Time and Motion Study.

Use of palliative care has increased substantially as the population ages and as evidence for its benefits grows. However, there is limited information regarding which care activities are necessary for delivering high-quality, interdisciplinary, community-based palliative care.This study aims to identify and measure the discrete clinical and administrative activities completed by a multidisciplinary team in a hospice provider-led model for providing community-based palliative care.A time and motion study was conducted at three care settings within a large hospice and palliative care network and a process map was drawn to describe the personnel and activities recorded.Researchers recorded activities performed by clinical and administrative staff. Activities were categorized into those related to patient care, administrative duties, care coordination, and other. A process map of palliative care delivery was created and descriptive statistics were used to calculate the proportion of time spent on discrete activities and within each activity category.Over 50 hours of activities were recorded during which the clinicians interacted with 25 patients and engaged in 20 distinct tasks. Physicians spent 94% of their time on tasks related to patient care and 1% on administrative tasks. Nurse practitioners and registered nurses spent 82% and 53% of their time on patient-related tasks and 2% and 37% on administrative tasks, respectively.The delivery of palliative care is interdisciplinary and involves numerous discrete tasks and activities. Understanding the components of a community-based palliative care model is the first step to designing incentives to encourage its spread.

Authors
Bhavsar, NA; Bloom, K; Nicolla, J; Gable, C; Goodman, A; Olson, A; Harker, M; Bull, J; Taylor, DH
MLA Citation
Bhavsar, NA, Bloom, K, Nicolla, J, Gable, C, Goodman, A, Olson, A, Harker, M, Bull, J, and Taylor, DH. "Delivery of Community-Based Palliative Care: Findings from a Time and Motion Study." Journal of palliative medicine 20.10 (October 2017): 1120-1126.
PMID
28562199
Source
epmc
Published In
Journal of Palliative Medicine
Volume
20
Issue
10
Publish Date
2017
Start Page
1120
End Page
1126
DOI
10.1089/jpm.2016.0433

One Size Does Not Fit All: Disease Profiles of Serious Illness Patients Receiving Specialty Palliative Care.

Understanding the symptom profiles of seriously ill patients who receive palliative care, especially noncancer diagnoses where the data are sparse and are critical to better targeting our resources to the needs of patients.We performed a retrospective, multicohort study of patients evaluated during their first consultative palliative care visit in a community-based palliative care registry. We placed into one of seven major disease categories based on clinician-reported primary diagnosis for consultation. Our primary aim of this analysis was to determine the univariate association between several patient-specific characteristics (e.g., demographics, care of setting, initial screening score) and the primary diagnosis.We evaluated the first visit consultation records of 1615 patients. Most prevalent diagnosis was Neurologic (564; 35%), followed by Cardiovascular (266; 16%), Pulmonary (229; 14%), and Cancer (208; 13%). Patients in the study with the highest symptom burden were those diagnosed with cancer or pulmonary disease, with 45% and 37% of cancer and pulmonary patients, respectively, having two or more moderate-to-severe symptoms; 26% of cardiovascular disease patients reported two or more moderate-to-severe symptoms, whereas 11% reported three or more. Patients with a neurologic or infectious diagnosis had less symptom burden, but a large percentage of neurologic patients were unable to respond.This study is one of the first to describe symptom burden and functional scores by diagnostic categories and care settings across a community-based interdisciplinary specialty palliative care program. Results demonstrated statistically significant and clinically relevant differences among settings of care, functional status, and symptom profiles between patients with various serious illnesses.

Authors
Kamal, AH; Taylor, DH; Neely, B; Harker, M; Bhullar, P; Morris, J; Bonsignore, L; Bull, J
MLA Citation
Kamal, AH, Taylor, DH, Neely, B, Harker, M, Bhullar, P, Morris, J, Bonsignore, L, and Bull, J. "One Size Does Not Fit All: Disease Profiles of Serious Illness Patients Receiving Specialty Palliative Care." Journal of pain and symptom management 54.4 (October 2017): 476-483.
PMID
28751079
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
54
Issue
4
Publish Date
2017
Start Page
476
End Page
483
DOI
10.1016/j.jpainsymman.2017.07.035

A Positive Association Between Hospice Profit Margin And The Rate At Which Patients Are Discharged Before Death.

Hospice care is designed to support patients and families through the final phase of illness and death. Yet for more than a decade, hospices have steadily increased the rate at which they discharge patients before death-a practice known as "live discharge." Although certain live discharges are consistent with high-quality care, regulators have expressed concern that some hospices' desire to maximize profits drives them to inappropriately discharge patients. We used Medicare claims data for 2012-13 and cost reports for 2011-13 to explore relationships between hospice-level financial margins and live discharge rates among freestanding hospices. Adjusted analyses showed positive and significant associations between both operating and total margins and hospice-level rates of live discharge: One-unit increases in operating and total margin were associated with increases of 3 percent and 4 percent in expected hospice-level live discharge rates, respectively. These findings suggest that additional research is needed to explore links between profitability and patient-centeredness in the Medicare hospice program.

Authors
Dolin, R; Holmes, GM; Stearns, SC; Kirk, DA; Hanson, LC; Taylor, DH; Silberman, P
MLA Citation
Dolin, R, Holmes, GM, Stearns, SC, Kirk, DA, Hanson, LC, Taylor, DH, and Silberman, P. "A Positive Association Between Hospice Profit Margin And The Rate At Which Patients Are Discharged Before Death." Health affairs (Project Hope) 36.7 (July 2017): 1291-1298.
PMID
28679817
Source
epmc
Published In
Health Affairs
Volume
36
Issue
7
Publish Date
2017
Start Page
1291
End Page
1298
DOI
10.1377/hlthaff.2017.0113

Comparing the Palliative Care Needs of Those With Cancer to Those With Common Non-Cancer Serious Illness.

Historically, palliative care has been focused on those with cancer. Although these ties persist, palliative care is rapidly integrating into the care of patients with common, non-cancer serious illnesses. Despite this, the bulk of literature informing palliative care practices stems from the care of cancer patients.We compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses-end-stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD).We conducted a cross-sectional, retrospective analysis of the characteristics and symptoms of patient's with ESRD, HF, COPD, and cancer at time of first specialty palliative care referral. Using a web-based point of care quality assessment and reporting tool, Quality Data and Collection Tool-Palliative care, this analysis evaluated all eligible patients who received a palliative care consultation between October 1, 2012 and November 25, 2014. Data were obtained from 13 participating sites. The primary outcome for the study was functionality using the palliative performance scale. Hospital admission in the last 30 days, prognosis, patient's understanding of prognosis, advanced care planning including code status and appointed decision maker, pain, fatigue, depression, and dyspnea were also evaluated as secondary outcomes. We tested for an association between our outcomes with disease type (cancer vs. non-cancer) fitting multivariable logistic regression models.We found that the patients with primary diagnoses other than cancer were less functional at time of referral (odds ratio: 1.6; 95% CI: 1.1, 2.3; P < 0.05).Patients with COPD, ESRD, and HF were less functional and more likely to be hospitalized at time of referral to palliative care than cancer patients. These findings may be reflective of the slower and more varied trajectory of non-cancer serious illness. One aim of palliative care for those with non-cancer severe illness should be directed toward improving and assisting with functionality and decreasing frequency of hospital admissions. These interventions could take place in the palliative care office, but could also be integrated into hospital discharge plans.

Authors
Bostwick, D; Wolf, S; Samsa, G; Bull, J; Taylor, DH; Johnson, KS; Kamal, AH
MLA Citation
Bostwick, D, Wolf, S, Samsa, G, Bull, J, Taylor, DH, Johnson, KS, and Kamal, AH. "Comparing the Palliative Care Needs of Those With Cancer to Those With Common Non-Cancer Serious Illness." Journal of pain and symptom management 53.6 (June 2017): 1079-1084.e1.
PMID
28457746
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
53
Issue
6
Publish Date
2017
Start Page
1079
End Page
1084.e1
DOI
10.1016/j.jpainsymman.2017.02.014

Death of outrage over talking about dying.

We examined public reaction to the proposed Center for Medicare and Medicaid Services rule reimbursing physicians for advanced care planning (ACP) discussions with patients.Public comments made on regulations.gov were reviewed for relevance to ACP policy and their perceived position on ACP (ie, positive, negative and neutral). Descriptive statistics were used to quantify the results.A total of 2225 comments were submitted to regulations.gov. On review, 69.0% were categorised as irrelevant; among relevant comments (n=689), 81.1% were positive, 18.6% were negative and 0.002% were neutral. Individuals submitted a greater percentage of the total comments as compared to organisations (63.5% and 36.5%, respectively).The US Medicare programme is a tax financed social insurance programme that covers all patients 65 years of age and older, including 8 in 10 decedents annually, and it is the part of the US healthcare system most similar to the rest of world. There has been a trend globally towards recognising the importance of aligning patient preferences with care options, including palliative care to deal with advanced life limiting illness. However, ACP is not widely used in the USA, potentially reducing the use of palliative care. Reimbursing ACP discussions between physicians, patients and their family has the potential to have a large impact on the quality of life of persons near death, which can greatly impact public health and the comfort in dealing with our ultimate demise.

Authors
Bhavsar, NA; Constand, S; Harker, M; Taylor, DH
MLA Citation
Bhavsar, NA, Constand, S, Harker, M, and Taylor, DH. "Death of outrage over talking about dying." BMJ supportive & palliative care (February 2, 2017).
PMID
28153856
Source
epmc
Published In
BMJ Supportive and Palliative Care
Publish Date
2017
DOI
10.1136/bmjspcare-2016-001182

The Case for Medicaid Expansion in North Carolina.

North Carolina's refusal to expand its Medicaid program has left many thousands of North Carolinians without health insurance and has imposed unnecessary costs on all of the state's residents through higher premiums in the state's health insurance marketplace. Expanding Medicaid is the most efficient way to extend coverage to the state's uninsured population, and expansion would bring a substantial amount of new federal money into the state. This money can serve as a catalyst for ambitious reforms to the Medicaid program that can lower costs, improve quality of care, and increase value for patients and taxpayers alike.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "The Case for Medicaid Expansion in North Carolina." North Carolina medical journal 78.1 (January 2017): 43-47.
PMID
28115565
Source
epmc
Published In
North Carolina Medical Journal
Volume
78
Issue
1
Publish Date
2017
Start Page
43
End Page
47
DOI
10.18043/ncm.78.1.43

Hospital-Based Palliative Care with Medicare Claims.

The prevalence of hospital-based palliative care has been largely anecdotal as an increasing service being provided and there is a need to understand what trends can be analyzed with Medicare data.To compare 2 methods of identifying hospital-based palliative care in the Medicare population in Colorado.Through Medicare claims data and phone surveys, we ascertained the presence of hospital-based palliative care services, number of patients receiving palliative care, and number of care visits provided during the previous year.Data were collected from every Medicare-certified hospital in Colorado during 2008 and 2013.We measured the presence of hospital-based palliative care teams and their average number of consultations through a phone survey and cross-referenced using a v-code modifier of Medicare claims indicating a palliative care consult visit.The number of hospital-based palliative care consultations increased five-fold from 2008-2013, and Medicare claims under-counted the number of these consultations compared to phone surveys.The systematic measurement of palliative care nationally is a key priority. More evidence is needed from other states to better understand the usefulness of Medicare claims in this effort.

Authors
Kassner, CT; Bhavsar, NA; Harker, M; Bull, J; Taylor, DH
MLA Citation
Kassner, CT, Bhavsar, NA, Harker, M, Bull, J, and Taylor, DH. "Hospital-Based Palliative Care with Medicare Claims." The American journal of hospice & palliative care (January 2017): 1049909117691020-.
PMID
28260393
Source
epmc
Published In
American Journal of Hospice & Palliative Medicine
Publish Date
2017
Start Page
1049909117691020
DOI
10.1177/1049909117691020

Identifying cancer patients who alter care or lifestyle due to treatment-related financial distress.

Cancer patients may experience financial distress as a side effect of their care. Little is known about which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress.We conducted a cross-sectional survey study to determine which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. Eligible patients were adults receiving cancer treatment enrolled between June 2010 and May 2011. We grouped coping strategies as lifestyle altering or care altering. We assessed coping strategies and relationships between covariates using descriptive statistics and analysis of variance.Among 174 participants, 89% used at least one lifestyle-altering coping strategy, while 39% used a care-altering strategy. Care-altering coping strategies adopted by patients included the following: not filling a prescription (28%) and taking less medication than prescribed (23%). Lifestyle-altering strategies included the following: spending less on leisure activities (77%), spending less on basics like food and clothing (57%), borrowing money (54%), and spending savings (50%). Younger patients were more likely than older patients to use coping strategies (p < 0.001). Lower-income patients adopted care-altering strategies more than higher-income patients (p = 0.03). Participants with more education and shorter duration of chemotherapy used lifestyle-altering strategies more than their counterparts (both p < 0.05).As a means of coping with treatment-related financial distress, patients were more likely to use lifestyle-altering approaches, but more than one-third adopted potentially harmful care-altering strategies. Younger age, lower income, higher education, and shorter duration of chemotherapy were characteristics associated with greater use of coping strategies. Copyright © 2015 John Wiley & Sons, Ltd.

Authors
Nipp, RD; Zullig, LL; Samsa, G; Peppercorn, JM; Schrag, D; Taylor, DH; Abernethy, AP; Zafar, SY
MLA Citation
Nipp, RD, Zullig, LL, Samsa, G, Peppercorn, JM, Schrag, D, Taylor, DH, Abernethy, AP, and Zafar, SY. "Identifying cancer patients who alter care or lifestyle due to treatment-related financial distress." Psycho-oncology 25.6 (June 2016): 719-725.
PMID
26149817
Source
epmc
Published In
Psycho-Oncology
Volume
25
Issue
6
Publish Date
2016
Start Page
719
End Page
725
DOI
10.1002/pon.3911

Adherence to Measuring What Matters Measures Using Point-of-Care Data Collection Across Diverse Clinical Settings.

Measuring What Matters (MWM) for palliative care has prioritized data collection efforts for evaluating quality in clinical practice. How these measures can be implemented across diverse clinical settings using point-of-care data collection on quality is unknown.To evaluate the implementation of MWM measures by exploring documentation of quality measure adherence across six diverse clinical settings inherent to palliative care practice.We deployed a point-of-care quality data collection system, the Quality Data Collection Tool, across five organizations within the Palliative Care Research Cooperative Group. Quality measures were recorded by clinicians or assistants near care delivery.During the study period, 1989 first visits were included for analysis. Our population was mostly white, female, and with moderate performance status. About half of consultations were seen on hospital general floors. We observed a wide range of adherence. The lowest adherence involved comprehensive assessments during the first visit in hospitalized patients in the intensive care unit (2.71%); the highest adherence across all settings, with an implementation of >95%, involved documentation of management of moderate/severe pain. We observed differences in adherence across clinical settings especially with MWM Measure #2 (Screening for Physical Symptoms, range 45.7%-81.8%); MWM Measure #5 (Discussion of Emotional Needs, range 46.1%-96.1%); and MWM Measure #6 (Documentation of Spiritual/Religious Concerns, range 0-69.6%).Variations in clinician documentation of adherence to MWM quality measures are seen across clinical settings. Additional studies are needed to better understand benchmarks and acceptable ranges for adherence tailored to various clinical settings.

Authors
Kamal, AH; Bull, J; Ritchie, CS; Kutner, JS; Hanson, LC; Friedman, F; Taylor, DH; AAHPM Research Committee Writing Group,
MLA Citation
Kamal, AH, Bull, J, Ritchie, CS, Kutner, JS, Hanson, LC, Friedman, F, Taylor, DH, and AAHPM Research Committee Writing Group, . "Adherence to Measuring What Matters Measures Using Point-of-Care Data Collection Across Diverse Clinical Settings." Journal of pain and symptom management 51.3 (March 2016): 497-503.
PMID
26854995
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
51
Issue
3
Publish Date
2016
Start Page
497
End Page
503
DOI
10.1016/j.jpainsymman.2015.12.313

What Contributes Most to High Health Care Costs? Health Care Spending in High Resource Patients.

U.S. health care spending nearly doubled in the decade from 2000-2010. Although the pace of increase has moderated recently, the rate of growth of health care costs is expected to be higher than the growth in the economy for the near future. Previous studies have estimated that 5% of patients account for half of all health care costs, while the top 1% of spenders account for over 27% of costs. The distribution of health care expenditures by type of service and the prevalence of particular health conditions for these patients is not clear, and is likely to differ from the overall population.To examine health care spending patterns and what contributes to costs for the top 5% of managed health care users based on total expenditures.This retrospective observational study employed a large administrative claims database analysis of health care claims of managed care enrollees across the full age and care spectrum. Direct health care expenditures were compared during calendar year 2011 by place of service (outpatient, inpatient, and pharmacy), payer type (commercially insured, Medicare Advantage, and Medicaid managed care), and therapy area between the full population and high resource patients (HRP).The mean total expenditure per HRP during calendar year 2011 was $43,104 versus $3,955 per patient for the full population. Treatment of back disorders and osteoarthritis contributed the largest share of expenditures in both HRP and the full study population, while chronic renal failure, heart disease, and some oncology treatments accounted for disproportionately higher expenditures in HRP. The share of overall expenditures attributed to inpatient services was significantly higher for HRP (40.0%) compared with the full population (24.6%), while the share of expenditures attributed to pharmacy (HRP = 18.1%, full = 21.4%) and outpatient services (HRP = 41.9%, full = 54.1%) was reduced. This pattern was observed across payer type. While the use of physician-administered pharmaceuticals was slightly higher in HRP, their use did not alter this spending pattern.Overall, expenditures in the HRP population are more than 10-fold higher compared with the full population. Managed care pharmacy can benefit from understanding what contributes to these higher costs, and managed care directors should consider an appropriately balanced assessment of the share of total spend by service and therapeutic category in HRP when devising drug usage and related cost-management strategies.

Authors
Pritchard, D; Petrilla, A; Hallinan, S; Taylor, DH; Schabert, VF; Dubois, RW
MLA Citation
Pritchard, D, Petrilla, A, Hallinan, S, Taylor, DH, Schabert, VF, and Dubois, RW. "What Contributes Most to High Health Care Costs? Health Care Spending in High Resource Patients." Journal of managed care & specialty pharmacy 22.2 (February 2016): 102-109.
PMID
27015249
Source
epmc
Published In
Journal of managed care & specialty pharmacy
Volume
22
Issue
2
Publish Date
2016
Start Page
102
End Page
109
DOI
10.18553/jmcp.2016.22.2.102

Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: a randomized clinical trial.

For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy for patients with limited life expectancy.To evaluate the safety, clinical, and cost impact of discontinuing statin medications for patients in the palliative care setting.This was a multicenter, parallel-group, unblinded, pragmatic clinical trial. Eligibility included adults with an estimated life expectancy of between 1 month and 1 year, statin therapy for 3 months or more for primary or secondary prevention of cardiovascular disease, recent deterioration in functional status, and no recent active cardiovascular disease. Participants were randomized to either discontinue or continue statin therapy and were monitored monthly for up to 1 year. The study was conducted from June 3, 2011, to May 2, 2013. All analyses were performed using an intent-to-treat approach.Statin therapy was withdrawn from eligible patients who were randomized to the discontinuation group. Patients in the continuation group continued to receive statins.Outcomes included death within 60 days (primary outcome), survival, cardiovascular events, performance status, quality of life (QOL), symptoms, number of nonstatin medications, and cost savings.A total of 381 patients were enrolled; 189 of these were randomized to discontinue statins, and 192 were randomized to continue therapy. Mean (SD) age was 74.1 (11.6) years, 22.0% of the participants were cognitively impaired, and 48.8% had cancer. The proportion of participants in the discontinuation vs continuation groups who died within 60 days was not significantly different (23.8% vs 20.3%; 90% CI, -3.5% to 10.5%; P=.36) and did not meet the noninferiority end point. Total QOL was better for the group discontinuing statin therapy (mean McGill QOL score, 7.11 vs 6.85; P=.04). Few participants experienced cardiovascular events (13 in the discontinuation group vs 11 in the continuation group). Mean cost savings were $3.37 per day and $716 per patient.This pragmatic trial suggests that stopping statin medication therapy is safe and may be associated with benefits including improved QOL, use of fewer nonstatin medications, and a corresponding reduction in medication costs. Thoughtful patient-provider discussions regarding the uncertain benefit and potential decrement in QOL associated with statin continuation in this setting are warranted.clinicaltrials.gov Identifier: NCT01415934.

Authors
Kutner, JS; Blatchford, PJ; Taylor, DH; Ritchie, CS; Bull, JH; Fairclough, DL; Hanson, LC; LeBlanc, TW; Samsa, GP; Wolf, S; Aziz, NM; Currow, DC; Ferrell, B; Wagner-Johnston, N; Zafar, SY; Cleary, JF; Dev, S; Goode, PS; Kamal, AH; Kassner, C; Kvale, EA; McCallum, JG; Ogunseitan, AB; Pantilat, SZ; Portenoy, RK; Prince-Paul, M; Sloan, JA; Swetz, KM; Von Gunten, CF; Abernethy, AP
MLA Citation
Kutner, JS, Blatchford, PJ, Taylor, DH, Ritchie, CS, Bull, JH, Fairclough, DL, Hanson, LC, LeBlanc, TW, Samsa, GP, Wolf, S, Aziz, NM, Currow, DC, Ferrell, B, Wagner-Johnston, N, Zafar, SY, Cleary, JF, Dev, S, Goode, PS, Kamal, AH, Kassner, C, Kvale, EA, McCallum, JG, Ogunseitan, AB, Pantilat, SZ, Portenoy, RK, Prince-Paul, M, Sloan, JA, Swetz, KM, Von Gunten, CF, and Abernethy, AP. "Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: a randomized clinical trial." JAMA internal medicine 175.5 (May 2015): 691-700.
PMID
25798575
Source
epmc
Published In
JAMA Internal Medicine
Volume
175
Issue
5
Publish Date
2015
Start Page
691
End Page
700
DOI
10.1001/jamainternmed.2015.0289

The palliative care in heart failure trial: rationale and design.

The progressive nature of heart failure (HF) coupled with high mortality and poor quality of life mandates greater attention to palliative care as a routine component of advanced HF management. Limited evidence exists from randomized, controlled trials supporting the use of interdisciplinary palliative care in HF.PAL-HF is a prospective, controlled, unblinded, single-center study of an interdisciplinary palliative care intervention in 200 patients with advanced HF estimated to have a high likelihood of mortality or rehospitalization in the ensuing 6 months. The 6-month PAL-HF intervention focuses on physical and psychosocial symptom relief, attention to spiritual concerns, and advanced care planning. The primary end point is health-related quality of life measured by the Kansas City Cardiomyopathy Questionnaire and the Functional Assessment of Chronic Illness Therapy with Palliative Care Subscale score at 6 months. Secondary end points include changes in anxiety/depression, spiritual well-being, caregiver satisfaction, cost and resource utilization, and a composite of death, HF hospitalization, and quality of life.PAL-HF is a randomized, controlled clinical trial that will help evaluate the efficacy and cost effectiveness of palliative care in advanced HF using a patient-centered outcome as well as clinical and economic end points.

Authors
Mentz, RJ; Tulsky, JA; Granger, BB; Anstrom, KJ; Adams, PA; Dodson, GC; Fiuzat, M; Johnson, KS; Patel, CB; Steinhauser, KE; Taylor, DH; O'Connor, CM; Rogers, JG
MLA Citation
Mentz, RJ, Tulsky, JA, Granger, BB, Anstrom, KJ, Adams, PA, Dodson, GC, Fiuzat, M, Johnson, KS, Patel, CB, Steinhauser, KE, Taylor, DH, O'Connor, CM, and Rogers, JG. "The palliative care in heart failure trial: rationale and design." American heart journal 168.5 (November 2014): 645-651.e1.
PMID
25440791
Source
epmc
Published In
American Heart Journal
Volume
168
Issue
5
Publish Date
2014
Start Page
645
End Page
651.e1
DOI
10.1016/j.ahj.2014.07.018

There is a mismatch between the medicare benefit package and the preferences of patients with cancer and their caregivers.

To identify insured services that are most important to Medicare beneficiaries with cancer and their family caregivers when coverage is limited.A total of 440 participants (patients, n = 246; caregivers, n = 194) were enrolled onto the CHAT (Choosing Health Plans All Together) study from August 2010 to March 2013. The exercise elicited preferences about what benefits Medicare should cover for patients with cancer in their last 6 months of life. Facilitated sessions lasted 2.5 hours, included 8 to 10 participants, and focused on choices about Medicare health benefits within the context of a resource-constrained environment.Six of 15 benefit categories were selected by > 80% of participants: cancer care, prescription drugs, primary care, home care, palliative care, and nursing home coverage. Only 12% of participants chose the maximum level of cancer benefits, a level of care commonly financed in the Medicare program. Between 40% and 50% of participants chose benefits not currently covered by Medicare: unrestricted cash, concurrent palliative care, and home-based long-term care. Nearly one in five participants picked some level of each of these three benefit categories and allocated on average 30% of their resources toward them.The mismatch between covered benefits and participant preferences shows that addressing quality of life and the financial burden of care is a priority for a substantial subset of patients with cancer in the Medicare program. Patient and caregiver preferences can be elicited, and the choices they express could suggest potential for Medicare benefit package reform and flexibility.

Authors
Taylor, DH; Danis, M; Zafar, SY; Howie, LJ; Samsa, GP; Wolf, SP; Abernethy, AP
MLA Citation
Taylor, DH, Danis, M, Zafar, SY, Howie, LJ, Samsa, GP, Wolf, SP, and Abernethy, AP. "There is a mismatch between the medicare benefit package and the preferences of patients with cancer and their caregivers." Journal of clinical oncology : official journal of the American Society of Clinical Oncology 32.28 (October 2014): 3163-3168.
PMID
25154830
Source
epmc
Published In
Journal of Clinical Oncology
Volume
32
Issue
28
Publish Date
2014
Start Page
3163
End Page
3168
DOI
10.1200/jco.2013.54.2605

A decision exercise to engage cancer patients and families in deliberation about Medicare coverage for advanced cancer care.

Concerns about unsustainable costs in the US Medicare program loom as the number of retirees increase and experiences serious and costly illnesses like cancer. Engagement of stakeholders, particularly cancer patients and their families, in prioritizing insured services offers a valuable strategy for informing Medicare coverage policy. We designed and evaluated a decision exercise that allowed cancer patients and family members to choose Medicare benefits for advanced cancer patients.The decision tool, Choosing Health plans All Together (CHAT) was modified to select services for advanced cancer patients. Patients with a cancer history (N = 246) and their family members (N = 194) from North Carolina participated in 70 CHAT sessions. Variables including participants' socio-demographic characteristics, health status, assessments of the exercise and results of group benefit selections were collected. Routine descriptive statistics summarized participant characteristics and Fisher's exact test compared group differences. Qualitative analysis of group discussions were used to ascertain reasons for or against selecting benefits.Patients and family members (N = 440) participated in 70 CHAT exercises. Many groups opted for such services as palliative care, nursing facilities, and services not currently covered by the Medicare program. In choosing among four levels of cancer treatment coverage, no groups chose basic coverage, 27 groups (39%) selected intermediate coverage, 39 groups (56%) selected high coverage, and 4 groups (6%) chose the most comprehensive cancer coverage. Reasons for or against benefit selection included fairness, necessity, need for prioritizing, personal experience, attention to family needs, holistic health outlook, preference for comfort, freedom of choice, and beliefs about the proper role of government. Participants found the exercise very easy (59%) or fairly easy (39%) to understand and very informative (66%) or fairly informative (31%). The majority agreed that the CHAT exercise led to fair decisions about priorities for coverage by which they could abide.It is possible to involve cancer patients and families in explicit discussions of their priorities for affordable advanced cancer care through the use of decision tools designed for this purpose. A key question is whether such a conversation is possible on a broader, national level.

Authors
Danis, M; Abernethy, AP; Zafar, SY; Samsa, GP; Wolf, SP; Howie, L; Taylor, DH
MLA Citation
Danis, M, Abernethy, AP, Zafar, SY, Samsa, GP, Wolf, SP, Howie, L, and Taylor, DH. "A decision exercise to engage cancer patients and families in deliberation about Medicare coverage for advanced cancer care." BMC health services research 14 (July 19, 2014): 315-.
PMID
25038783
Source
epmc
Published In
BMC Health Services Research
Volume
14
Publish Date
2014
Start Page
315
DOI
10.1186/1472-6963-14-315

Quality measures for palliative care in patients with cancer: a systematic review.

Quality assessment is a critical component of determining the value of medical services, including palliative care. Characterization of the current portfolio of measures that assess the quality of palliative care delivered in oncology is necessary to identify gaps and inform future measure development.We performed a systematic review of MEDLINE/PubMed and the gray literature for quality measures relevant to palliative care. Measures were categorized into National Quality Forum domains and reviewed for methodology of development and content. Measures were additionally analyzed to draw summative conclusions on scope and span.Two hundred eighty-four quality measures within 13 measure sets were identified. The most common domains for measure content were Physical Aspects of Care (35%) and Structure and Processes of Care (22%). Of symptom-related measures, pain (36%) and dyspnea (26%) were the most commonly addressed. Spiritual (4%) and Cultural (1%) Aspects of Care were least represented domains. Generally, measures addressed processes of care, did not delineate benchmarks for success, and often did not specify intended interventions to address unmet needs. This was most evident regarding issues of psychosocial and spiritual assessment and management.Within a large cohort of quality measures for palliative, care is often a focus on physical manifestations of disease and adverse effects of therapy; relatively little attention is given to the other aspects of suffering commonly observed among patients with advanced cancer, including psychological, social, and spiritual distress.

Authors
Kamal, AH; Gradison, M; Maguire, JM; Taylor, D; Abernethy, AP
MLA Citation
Kamal, AH, Gradison, M, Maguire, JM, Taylor, D, and Abernethy, AP. "Quality measures for palliative care in patients with cancer: a systematic review." Journal of oncology practice 10.4 (July 2014): 281-287. (Review)
PMID
24917264
Source
epmc
Published In
Journal of Oncology Practice
Volume
10
Issue
4
Publish Date
2014
Start Page
281
End Page
287
DOI
10.1200/jop.2013.001212

Physician and Patient and Caregiver Health Attitudes and Their Effect on Medicare Resource Allocation for Patients With Advanced Cancer.

Physicians must participate in end-of-life discussions, but they understand poorly their patients' end-of-life values and preferences. A better understanding of these preferences and the effect of baseline attitudes will improve end-of-life discussions.To determine how baseline attitudes toward quality vs quantity of life affect end-of-life resource allocation.Otolaryngology-head and neck surgery (OHNS) physicians were recruited to use a validated online tool to create a Medicare health plan for advanced cancer patients. During the exercise, participants allocated a limited pool of resources among 15 benefit categories. These data were compared with preliminary data from patients with cancer and their caregivers obtained from a separate study using the same tool. Attitudes toward quality vs quantity of life were assessed for both physicians and patients and caregivers.Participation in online assessment exercise.Medicare resource allocation.Of 9120 OHNS physicians e-mailed, 767 participated. Data collected from this group were compared with data collected from 146 patients and 114 caregivers. Compared with patients and caregivers, OHNS physician allocations differed significantly in all 15 benefit categories except home care. When stratified by answers to 3 questions about baseline attitudes toward quality vs quantity of life, there were 3 categories in which allocations of patients and caregivers differed significantly from the group with the opposite attitude for at least 2 questions: other medical care (question 1, P < .001; question 2, P = .005), palliative care (question 1, P = .008; question 2, P = .006; question 3, P = .009), and treatment for cancer (questions 1 and 2, P < .001). In contrast, physician preferences showed significant differences in only 1, nonmatching category for each attitude question: cash (question 1, P = .02), drugs (question 2, P = .03), and home care (question 3, P = .048).Patients with cancer and their caregivers have different preferences from physicians. These preferences are, for these patients and their caregivers, affected by their baseline health attitudes, but physician preferences are not. Understanding the effect of baseline attitudes is important for effective end-of-life discussions.

Authors
Rocke, DJ; Beumer, HW; Taylor, DH; Thomas, S; Puscas, L; Lee, WT
MLA Citation
Rocke, DJ, Beumer, HW, Taylor, DH, Thomas, S, Puscas, L, and Lee, WT. "Physician and Patient and Caregiver Health Attitudes and Their Effect on Medicare Resource Allocation for Patients With Advanced Cancer." JAMA otolaryngology-- head & neck surgery 140.6 (June 2014): 497-503.
PMID
24763550
Source
epmc
Published In
JAMA Otolaryngology - Head and Neck Surgery
Volume
140
Issue
6
Publish Date
2014
Start Page
497
End Page
503
DOI
10.1001/jamaoto.2014.494

HEALTH CARE SPENDING PATTERNS IN HIGH RESOURCE PATIENTS

Authors
Pritchard, DE; Petrilla, AA; Hallinan, S; Jr, TDH; Schabert, VF; Dubois, RW
MLA Citation
Pritchard, DE, Petrilla, AA, Hallinan, S, Jr, TDH, Schabert, VF, and Dubois, RW. "HEALTH CARE SPENDING PATTERNS IN HIGH RESOURCE PATIENTS." VALUE IN HEALTH 17.3 (May 2014): A148-A148.
Source
wos-lite
Published In
Value in Health
Volume
17
Issue
3
Publish Date
2014
Start Page
A148
End Page
A148

Self-reported financial burden and satisfaction with care among patients with cancer.

Health care-related costs and satisfaction are compelling targets for quality improvement in cancer care delivery; however, little is known about how financial burden affects patient satisfaction.This was an observational, cross-sectional, survey-based study assessing patient-reported financial burden (FB). Eligible patients were ≥ 21 years with solid tumor malignancy and were receiving chemotherapy or hormonal therapy for ≥ 1 month. The Patient Satisfaction Questionnaire Short-Form assessed patient satisfaction with health care. Subjective FB related to cancer treatment was measured on a 5-point Likert scale.Of 174 participants (32% response rate), 47% reported significant/catastrophic FB. Participants reported highest satisfaction with interpersonal manner and lowest satisfaction with financial aspects of care. In adjusted analysis, high FB was negatively associated with general satisfaction (coefficient: -.29), satisfaction with technical quality (coefficient: -.26), and satisfaction with financial aspects of care (coefficient: -.62). Older age was associated with higher scores in all satisfaction subscales except patient-physician communication and financial aspects. Annual household income of <$20,000 was associated with lower satisfaction scores in all subscales except time spent with doctor. High FB was not associated with patient satisfaction scores for accessibility and convenience, communication, interpersonal manner, or time spent with doctor.FB is a potentially modifiable correlate of poor satisfaction with cancer care including general satisfaction and satisfaction with the technical quality of care. Addressing cancer-associated FB may lead to improved satisfaction, which in turn can influence adherence, outcomes, and quality of life.

Authors
Chino, F; Peppercorn, J; Taylor, DH; Lu, Y; Samsa, G; Abernethy, AP; Zafar, SY
MLA Citation
Chino, F, Peppercorn, J, Taylor, DH, Lu, Y, Samsa, G, Abernethy, AP, and Zafar, SY. "Self-reported financial burden and satisfaction with care among patients with cancer." The oncologist 19.4 (April 2014): 414-420.
PMID
24668333
Source
epmc
Published In
The oncologist
Volume
19
Issue
4
Publish Date
2014
Start Page
414
End Page
420
DOI
10.1634/theoncologist.2013-0374

The palliative care in heart failure trial: Rationale and design

© 2014 Elsevier Inc. All rights reserved. Background: The progressive nature of heart failure (HF) coupled with high mortality and poor quality of life mandates greater attention to palliative care as a routine component of advanced HF management. Limited evidence exists from randomized, controlled trials supporting the use of interdisciplinary palliative care in HF. Methods: PAL-HF is a prospective, controlled, unblinded, single-center study of an interdisciplinary palliative care intervention in 200 patients with advanced HF estimated to have a high likelihood of mortality or rehospitalization in the ensuing 6 months. The 6-month PAL-HF intervention focuses on physical and psychosocial symptom relief, attention to spiritual concerns, and advanced care planning. The primary end point is health-related quality of life measured by the Kansas City Cardiomyopathy Questionnaire and the Functional Assessment of Chronic Illness Therapy with Palliative Care Subscale score at 6 months. Secondary end points include changes in anxiety/depression, spiritual well-being, caregiver satisfaction, cost and resource utilization, and a composite of death, HF hospitalization, and quality of life. Conclusions: PAL-HF is a randomized, controlled clinical trial that will help evaluate the efficacy and cost effectiveness of palliative care in advanced HF using a patient-centered outcome as well as clinical and economic end points.

Authors
Mentz, RJ; Tulsky, JA; Granger, BB; Anstrom, KJ; Adams, PA; Dodson, GC; Fiuzat, M; Johnson, KS; Patel, CB; Steinhauser, KE; Taylor, DH; O'Connor, CM; Rogers, JG
MLA Citation
Mentz, RJ, Tulsky, JA, Granger, BB, Anstrom, KJ, Adams, PA, Dodson, GC, Fiuzat, M, Johnson, KS, Patel, CB, Steinhauser, KE, Taylor, DH, O'Connor, CM, and Rogers, JG. "The palliative care in heart failure trial: Rationale and design." American Heart Journal 168.5 (January 1, 2014): 645-651.e1.
Source
scopus
Published In
American Heart Journal
Volume
168
Issue
5
Publish Date
2014
Start Page
645
End Page
651.e1
DOI
10.1016/j.ahj.2014.07.018

Targeted investment improves access to hospice and palliative care

Context: Availability of hospice and palliative care is increasing, despite lack of a clear national strategy for developing and evaluating their penetration into and impact on the target population. Objectives: To determine whether targeted investment (i.e., strategic grants made by one charitable foundation) in hospice and palliative care in one U.S. state (North Carolina [NC]) led to improved access to end-of-life care services as indicated by hospice utilization. Methods: Access was measured by the death service ratio (DSR), defined as the proportion of people who died and were served by hospice for at least one day before death. Calculation of the DSR is based on counts of patients accessing hospice by county in a given year (numerator) and U.S. Census projected population data for that county (denominator). Multilevel modeling was the primary analytic strategy used to generate two models: 1) comparison of the DSR in counties with vs. without philanthropic funding and 2) relationship between years since receipt of a philanthropic grant and DSR. Results: In NC, the average DSR increased from 20.7% in 2003 to 35.8% in 2009 (55% increase). In 2009, 82 of 100 NC counties had a DSR below the U.S. average (41.6%). In Model 1, significant associations were found between county population and DSR (P = 0.03) and between receipt of philanthropic funding and DSR (P = 0.01); on average, funded counties had a DSR that was 2.63 percentage points higher than unfunded counties. Conclusion: Receipt of philanthropic funding appeared to be associated with improved access to palliative care and hospice services in NC. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Authors
Abernethy, AP; Bull, J; Whitten, E; Shelby, R; Wheeler, JL; Taylor, DH
MLA Citation
Abernethy, AP, Bull, J, Whitten, E, Shelby, R, Wheeler, JL, and Taylor, DH. "Targeted investment improves access to hospice and palliative care." Journal of Pain and Symptom Management 46.5 (November 1, 2013): 629-639.
Source
scopus
Published In
Journal of Pain and Symptom Management
Volume
46
Issue
5
Publish Date
2013
Start Page
629
End Page
639
DOI
10.1016/j.jpainsymman.2012.12.012

Targeted investment improves access to hospice and palliative care.

CONTEXT: Availability of hospice and palliative care is increasing, despite lack of a clear national strategy for developing and evaluating their penetration into and impact on the target population. OBJECTIVES: To determine whether targeted investment (i.e., strategic grants made by one charitable foundation) in hospice and palliative care in one U.S. state (North Carolina [NC]) led to improved access to end-of-life care services as indicated by hospice utilization. METHODS: Access was measured by the death service ratio (DSR), defined as the proportion of people who died and were served by hospice for at least one day before death. Calculation of the DSR is based on counts of patients accessing hospice by county in a given year (numerator) and U.S. Census projected population data for that county (denominator). Multilevel modeling was the primary analytic strategy used to generate two models: 1) comparison of the DSR in counties with vs. without philanthropic funding and 2) relationship between years since receipt of a philanthropic grant and DSR. RESULTS: In NC, the average DSR increased from 20.7% in 2003 to 35.8% in 2009 (55% increase). In 2009, 82 of 100 NC counties had a DSR below the U.S. average (41.6%). In Model 1, significant associations were found between county population and DSR (P=0.03) and between receipt of philanthropic funding and DSR (P=0.01); on average, funded counties had a DSR that was 2.63 percentage points higher than unfunded counties. CONCLUSION: Receipt of philanthropic funding appeared to be associated with improved access to palliative care and hospice services in NC.

Authors
Abernethy, AP; Bull, J; Whitten, E; Shelby, R; Wheeler, JL; Taylor, DH
MLA Citation
Abernethy, AP, Bull, J, Whitten, E, Shelby, R, Wheeler, JL, and Taylor, DH. "Targeted investment improves access to hospice and palliative care." J Pain Symptom Manage 46.5 (November 2013): 629-639.
PMID
23669467
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
46
Issue
5
Publish Date
2013
Start Page
629
End Page
639
DOI
10.1016/j.jpainsymman.2012.12.012

The effect of palliative care on patient functioning.

BACKGROUND: Palliative care is increasingly viewed as a care option that should not only be offered to patients very near the end of life. An important question is whether increased use of palliative care soon after a patient's referral will improve patient functioning, an aspect of quality of life. OBJECTIVES: The aim of this study was to determine if increased use of palliative care is associated with increased patient functioning. METHODS: The Carolinas Palliative Care Database Consortium collects palliative care encounter data from a variety of providers, settings, and patients, and it measures patient functioning, allowing us to test the hypothesis that increased use of palliative care early in a patient's palliative care experience will improve patient functioning. RESULTS: After controlling for other factors that could explain patient functioning, we find that each additional palliative care visit during the first month of follow-up increases patient functioning measured using an area under the curve (AUC) approach (0.008 per visit, p=0.01). However, patient functioning as measured at the initial visit is a far stronger predictor of subsequent functioning (0.52, p<0.001) than are additional palliative care visits. CONCLUSIONS: Increased use of palliative care was associated with improved patient functioning. This held true at very low as well as very high levels of initial functioning. The strongest predictor of subsequent patient functioning is their initial status. Accounting for patient-specific differences to precisely determine the impact of palliative care on patient functioning is difficult.

Authors
Taylor, DH; Bull, J; Zhong, X; Samsa, G; Abernethy, AP
MLA Citation
Taylor, DH, Bull, J, Zhong, X, Samsa, G, and Abernethy, AP. "The effect of palliative care on patient functioning." J Palliat Med 16.10 (October 2013): 1227-1231.
PMID
24020918
Source
pubmed
Published In
Journal of Palliative Medicine
Volume
16
Issue
10
Publish Date
2013
Start Page
1227
End Page
1231
DOI
10.1089/jpm.2013.0040

Medicare as insurance innovator: the case of hospice.

The stylized fact is that while private insurance has tended to innovate on the benefit design side of the insurance contract, Medicare has lead innovation on the payment side. Traditional or Fee-For-Service Medicare has produced many innovations in the payment for health care services, such as Prospective Payment for hospitals, Diagnostic-Related Groups to categorize care, and the Resource-Based Relative Value System used by the program to pay physicians, while private insurance has produced a series of benefit design innovations. This story misses one important example of Medicare benefit innovation: the creation of the Medicare hospice benefit. A key question is whether Medicare can again lead a system-wide benefit design effort to improve upon current hospice and palliative care policy.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Medicare as insurance innovator: the case of hospice." Am J Hosp Palliat Care 30.6 (September 2013): 556-557.
PMID
23015729
Source
pubmed
Published In
American Journal of Hospice & Palliative Medicine
Volume
30
Issue
6
Publish Date
2013
Start Page
556
End Page
557
DOI
10.1177/1049909112461064

Financial Distress, Use of Cost-Coping Strategies, and Adherence to Prescription Medication Among Patients With Cancer.

The relationship between prescription medication adherence and financial burden is understudied, particularly in patients seeking financial assistance.

Authors
Zullig, LL; Peppercorn, JM; Schrag, D; Taylor, DH; Lu, Y; Samsa, G; Abernethy, AP; Zafar, SY
MLA Citation
Zullig, LL, Peppercorn, JM, Schrag, D, Taylor, DH, Lu, Y, Samsa, G, Abernethy, AP, and Zafar, SY. "Financial Distress, Use of Cost-Coping Strategies, and Adherence to Prescription Medication Among Patients With Cancer." J Oncol Pract (August 20, 2013).
PMID
23981344
Source
pubmed
Published In
Journal of Oncology Practice
Publish Date
2013
DOI
10.1200/JOP.2013.000971

Physician allocation of Medicare resources for patients with advanced cancer.

BACKGROUND: Little is known about what patients and physicians value in end-of-life care, or how these groups would craft a health plan for those with advanced cancer. OBJECTIVE: The study objective was to assess how otolaryngology, head and neck surgery (OHNS) physicians would structure a Medicare benefit plan for patients with advanced cancer, and to compare this with cancer patient and cancer patient caregiver preferences. DESIGN: OHNS physicians used an online version of a validated tool for assessing preferences for health plans in the setting of limited resources. These data were compared to cancer patient and caregiver preferences. SETTING AND PARTICIPANTS: OHNS physicians nationwide were assessed with comparison to similar data obtained in a separate study of cancer patients and their caregivers treated at Duke University Medical Center. RESULTS: Otolaryngology physicians (n=767) completed the online assessment and this was compared with data from 146 patients and 114 caregivers. OHNS physician allocations differed significantly in 14 of the 15 benefit categories when compared with patients and caregivers. Physicians elected more coverage in the Advice, Emotional Care, Palliative Care, and Treatment for Cancer benefit categories. Patients and their caregivers elected more coverage in the Cash, Complementary Care, Cosmetic Care, Dental and Vision, Drug Coverage, Home Improvement, House Calls, Nursing Facility, Other Medical Care, and Primary Care benefit categories. CONCLUSIONS: Otolaryngology physicians have significantly different values in end-of-life care than cancer patients and their caregivers. This information is important for efficient allocation of scarce Medicare resources and for effective end-of-life discussions, both of which are key for developing appropriate health policy.

Authors
Rocke, DJ; Lee, WT; Beumer, HW; Taylor, DH; Schulz, K; Thomas, S; Puscas, L
MLA Citation
Rocke, DJ, Lee, WT, Beumer, HW, Taylor, DH, Schulz, K, Thomas, S, and Puscas, L. "Physician allocation of Medicare resources for patients with advanced cancer." J Palliat Med 16.8 (August 2013): 857-866.
PMID
23802131
Source
pubmed
Published In
Journal of Palliative Medicine
Volume
16
Issue
8
Publish Date
2013
Start Page
857
End Page
866
DOI
10.1089/jpm.2012.0636

The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience.

PURPOSE: Cancer patients carry rising burdens of health care-related out-of-pocket expenses, and a growing number of patients are considered "underinsured." Our objective was to describe experiences of insured cancer patients requesting copayment assistance and to describe the impact of health care expenses on well-being and treatment. METHODS: We conducted baseline and follow-up surveys regarding the impact of health care costs on well-being and treatment among cancer patients who contacted a national copayment assistance foundation along with a comparison sample of patients treated at an academic medical center. RESULTS: Among 254 participants, 75% applied for drug copayment assistance. Forty-two percent of participants reported a significant or catastrophic subjective financial burden; 68% cut back on leisure activities, 46% reduced spending on food and clothing, and 46% used savings to defray out-of-pocket expenses. To save money, 20% took less than the prescribed amount of medication, 19% partially filled prescriptions, and 24% avoided filling prescriptions altogether. Copayment assistance applicants were more likely than nonapplicants to employ at least one of these strategies to defray costs (98% vs. 78%). In an adjusted analysis, younger age, larger household size, applying for copayment assistance, and communicating with physicians about costs were associated with greater subjective financial burden. CONCLUSION: Insured patients undergoing cancer treatment and seeking copayment assistance experience considerable subjective financial burden, and they may alter their care to defray out-of-pocket expenses. Health insurance does not eliminate financial distress or health disparities among cancer patients. Future research should investigate coverage thresholds that minimize adverse financial outcomes and identify cancer patients at greatest risk for financial toxicity.

Authors
Zafar, SY; Peppercorn, JM; Schrag, D; Taylor, DH; Goetzinger, AM; Zhong, X; Abernethy, AP
MLA Citation
Zafar, SY, Peppercorn, JM, Schrag, D, Taylor, DH, Goetzinger, AM, Zhong, X, and Abernethy, AP. "The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience." Oncologist 18.4 (2013): 381-390.
PMID
23442307
Source
pubmed
Published In
The oncologist
Volume
18
Issue
4
Publish Date
2013
Start Page
381
End Page
390
DOI
10.1634/theoncologist.2012-0279

Copayment assistance and adherence to prescription medication among patients with cancer

Authors
Zullig, LL; Peppercorn, JM; Schrag, D; Taylor, DH; Zhong, X; Samsa, G; Abernethy, AP; Zafar, Y
MLA Citation
Zullig, LL, Peppercorn, JM, Schrag, D, Taylor, DH, Zhong, X, Samsa, G, Abernethy, AP, and Zafar, Y. "Copayment assistance and adherence to prescription medication among patients with cancer." JOURNAL OF CLINICAL ONCOLOGY 30.34 (December 1, 2012).
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
30
Issue
34
Publish Date
2012

Balancing the Budget is a Progressive Priority

Progressives need a balanced federal budget more than Conservatives, because they believe that government has an important role to play in modern life. Lack of a long term plan to move toward a sustainable budget crowds out short term Progressive priorities: infrastructure spending, green technology, education and needed governmental interventions in the short term to support and improve our weak economy. The federal budget is unsustainable. For all the bluster of the debt ceiling debate, the plan passed so far does not address the changes most obviously needed if we are to ever have a balanced budget again: an increase in taxes and the next steps on health reform to address the biggest driver of our long term budget deficit, health care costs. Slowing the rate at which health care costs are growing is a necessary, but not a sufficient condition to developing a long range balanced budget. You should ask any politician saying they think a balanced budget is a priority one question: what is your health reform plan? Without one, they have no hope of achieving their goal. This book offers progressives solutions to health care reform and a balanced budget, and will be of interest to academics, students and educated readers interested in politics, public policy and government finance.

Authors
Taylor, DH
MLA Citation
Taylor, DH. Balancing the Budget is a Progressive Priority. 2012.
Source
manual
Publish Date
2012

Palliative care needs of patients with cancer living in the community.

PURPOSE: With improved effectiveness of early detection and treatment, many patients with cancer are now living with advanced disease and associated symptoms. As cancer becomes a chronic illness, adequate attention to patients' symptoms and psychosocial needs in the community setting requires positioning of palliative care alongside cancer care. This article describes the current palliative care needs of a population of community-dwelling patients with advanced cancer who are not yet ready for transition to hospice. METHODS: This secondary analysis used quality-monitoring data collected in three community-based palliative care organizations. Analyses focused on people with cancer-related diagnoses who were receiving palliative care during 2008 to 2011. RESULTS: The analytic data set included 4,980 people, 10% of whom had cancer. Median age was 71 years. Forty-eight percent had been hospitalized at least once in the 6 months before palliative care referral. Forty-nine percent had a Palliative Performance Score (PPS) of 40% to 60%; 40% had PPS ≤ 30%. Although 81% had an estimated prognosis of ≤ 6 months, 58% were expected to live weeks to months. Thirty-three percent had no identified healthcare surrogate; 59% had no do-not-resuscitate order despite declining functional status and limited prognosis. Ninety-five percent reported ≥ 1 symptom, and 67% reported ≥ 3 symptoms; a substantial proportion did not receive treatment for symptoms. CONCLUSIONS: Patients referred to community-based palliative care experience multiple often-severe symptoms that have been insufficiently addressed. They tend to have declining performance status. Earlier palliative care intervention could improve outcomes but will require delivery models that better coordinate inpatient/outpatient oncology and community-based palliative care.

Authors
Kamal, AH; Bull, J; Kavalieratos, D; Taylor, DH; Downey, W; Abernethy, AP
MLA Citation
Kamal, AH, Bull, J, Kavalieratos, D, Taylor, DH, Downey, W, and Abernethy, AP. "Palliative care needs of patients with cancer living in the community." J Oncol Pract 7.6 (November 2011): 382-388.
PMID
22379422
Source
pubmed
Published In
Journal of Oncology Practice
Volume
7
Issue
6
Publish Date
2011
Start Page
382
End Page
388
DOI
10.1200/JOP.2011.000455

Death service ratio: a measure of hospice utilization and cost impact.

Authors
Abernethy, AP; Kassner, CT; Whitten, E; Bull, J; Taylor, DH
MLA Citation
Abernethy, AP, Kassner, CT, Whitten, E, Bull, J, and Taylor, DH. "Death service ratio: a measure of hospice utilization and cost impact." J Pain Symptom Manage 41.6 (June 2011): e5-e6. (Letter)
PMID
21621129
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
41
Issue
6
Publish Date
2011
Start Page
e5
End Page
e6
DOI
10.1016/j.jpainsymman.2011.03.004

Impact of out-of-pocket expenses on cancer care

Authors
Zafar, Y; Goetzinger, AM; Fowler, R; Gblokpor, A; Warhadpande, D; Taylor, DH; Schrag, D; Peppercorn, JM; Abernethy, AP
MLA Citation
Zafar, Y, Goetzinger, AM, Fowler, R, Gblokpor, A, Warhadpande, D, Taylor, DH, Schrag, D, Peppercorn, JM, and Abernethy, AP. "Impact of out-of-pocket expenses on cancer care." JOURNAL OF CLINICAL ONCOLOGY 29.15 (May 20, 2011).
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
29
Issue
15
Publish Date
2011

Impact of out-of-pocket expenses on cancer care.

6006 Background: How do out-of-pocket expenses for cancer care (OOPE) impact patient-reported lifestyle, quality, and satisfaction with cancer care?We recruited patients at Duke University Medical Center and from a national pool of applicants to the Healthwell Foundation (HF), a non-profit organization which assists the underinsured with healthcare costs. Eligible patients were receiving breast, lung, or colorectal cancer treatment. Eligibility was independent of receiving HF assistance. We did not share identified data with HF. Patients completed surveys on strategies to cope with OOPE, satisfaction with care, and 4 weekly expense diaries. Associations between demographics, coping strategies, and OOPE were examined.127 patients were enrolled (85% via HF), with a mean age of 65 years (range 41-88). Most were Caucasian (84%), female (94%), had breast cancer (84%), and had non-metastatic cancer (60%). All were insured; 64% had Medicare or Medicare plus supplemental insurance. 22% were employed, 51% were retired, and 73% had annual household income <$40,000. 45% perceived a significant or catastrophic financial burden with OOPE. OOPE averaged $1266/month. The largest proportion of OOPE was attributed to prescription medication ($523/month, 41%). Other monthly costs included: medical equipment ($197; 14%), travel ($122; 10%), special diet ($72; 6%), and non-prescription drugs ($68; 5%). As financial burden increased, patients used more strategies to cope with OOPE (p<0.001). To cope with OOPE, 52% spent less on food and clothing, 76% spent less on leisure activities like eating out or movies, 47% used all or part of their savings, 30% did not fill prescriptions, 20% took less medication than prescribed, and 49% borrowed money to pay for prescriptions. Older patients reported less financial burden compared to younger patients (p<0.001). Patients with greater financial burden reported lower levels of satisfaction with their cancer care (p=0.001).OOPE incurred by underinsured cancer patients triggered considerable lifestyle changes. OOPE might impact cancer care quality as patients took fewer prescribed medications. Patients saddled with OOPE were less satisfied with cancer care. OOPE thus diminished care at multiple levels.

Authors
Zafar, Y; Goetzinger, AM; Fowler, R; Gblokpor, A; Warhadpande, D; Taylor, DH; Schrag, D; Peppercorn, JM; Abernethy, AP
MLA Citation
Zafar, Y, Goetzinger, AM, Fowler, R, Gblokpor, A, Warhadpande, D, Taylor, DH, Schrag, D, Peppercorn, JM, and Abernethy, AP. "Impact of out-of-pocket expenses on cancer care." Journal of clinical oncology : official journal of the American Society of Clinical Oncology 29.15_suppl (May 2011): 6006-.
PMID
28022013
Source
epmc
Published In
Journal of Clinical Oncology
Volume
29
Issue
15_suppl
Publish Date
2011
Start Page
6006

Palliative care and the search for value in health reform.

Improving value in health care is of paramount importance, and doing so will require focus on both the costs and benefits of care. Palliative care addresses symptoms of disease regardless of prognosis, helps patients clarify their goals of care, and is key in improving value in the health care system.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Palliative care and the search for value in health reform." N C Med J 72.3 (May 2011): 229-231.
PMID
21901924
Source
pubmed
Published In
North Carolina Medical Journal
Volume
72
Issue
3
Publish Date
2011
Start Page
229
End Page
231

Lower extremity physical performance, self-reported mobility difficulty, and use of compensatory strategies for mobility by elderly women.

OBJECTIVE: To describe the relationship between lower extremity physical performance, self-reported mobility difficulty, and self-reported use of compensatory strategies (CSs) for mobility inside the home. DESIGN: Cross-sectional exploratory study. SETTING: Community-dwelling elders. PARTICIPANTS: Disabled, cognitively intact women 65 years or older (N=1002), from the Women's Health and Aging Study I. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: CS scale: no CS, behavioral modifications (BMs) only, durable medical equipment (DME) with or without use of BMs, and any use of human help (HH); and 3 dichotomous CS measures: any CS (vs none); DME+HH (vs BMs only, among users of any CS); any HH (vs DME only, among users of any DME/HH). RESULTS: Self-reported mobility difficulty and physical performance were significantly correlated with one another (r=-.57, P<.0001) and with the CS scale ([r=.51, P<.001] and [r=-.54, P<.0001], respectively). Sequential logistic regressions showed self-reported difficulty and physical performance were significant independent predictors of each category of CS. For the any CS and DME+HH models, the odds ratio for self-reported difficulty decreased by approximately 50% when physical performance was included in the model, compared with difficulty alone ([18.0 to 8.6] and [7.3 to 3.8], respectively), but both physical performance and difficulty remained significant predictors (P<.0001). The effects of covariates differed for the various CS categories, with some covariates having independent relationships to CS, and others appearing to have moderating or mediating effects on the relationship of self-reported difficulty or physical performance to CS. CONCLUSIONS: Physical performance, self-reported difficulty, health conditions, and contextual factors have complex effects on the way elders carry out mobility inside the home.

Authors
Ganesh, SP; Fried, LP; Taylor, DH; Pieper, CF; Hoenig, HM
MLA Citation
Ganesh, SP, Fried, LP, Taylor, DH, Pieper, CF, and Hoenig, HM. "Lower extremity physical performance, self-reported mobility difficulty, and use of compensatory strategies for mobility by elderly women." Arch Phys Med Rehabil 92.2 (February 2011): 228-235.
PMID
21272718
Source
pubmed
Published In
Archives of Physical Medicine and Rehabilitation
Volume
92
Issue
2
Publish Date
2011
Start Page
228
End Page
235
DOI
10.1016/j.apmr.2010.10.012

Genetic testing for Alzheimer's and long-term care insurance.

A genetic marker known as apolipoprotein E provides a clear signal of a person's risk of developing Alzheimer's disease and thus that person's future need for long-term care. People who find that they have the variant of the trait that increases Alzheimer's disease risk are more likely to purchase long-term care insurance after receiving this information. If the information is widely introduced into the insurance market, coverage rates could be affected in different ways, depending on who possesses that information. Policymakers will eventually need to confront the issue of the use of this and other markers in the pricing of long-term care insurance.

Authors
Taylor, DH; Cook-Deegan, RM; Hiraki, S; Roberts, JS; Blazer, DG; Green, RC
MLA Citation
Taylor, DH, Cook-Deegan, RM, Hiraki, S, Roberts, JS, Blazer, DG, and Green, RC. "Genetic testing for Alzheimer's and long-term care insurance." Health Aff (Millwood) 29.1 (January 2010): 102-108.
PMID
20048367
Source
pubmed
Published In
Health Affairs
Volume
29
Issue
1
Publish Date
2010
Start Page
102
End Page
108
DOI
10.1377/hlthaff.2009.0525

Health reform. Or not?

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Health reform. Or not?." N C Med J 71.1 (January 2010): 26-27.
PMID
20369668
Source
pubmed
Published In
North Carolina Medical Journal
Volume
71
Issue
1
Publish Date
2010
Start Page
26
End Page
27

Is a home-care network necessary to access the Medicare hospice benefit?

OBJECTIVE: To test whether the presence of an informal or formal care network in the home leads to different hospice utilization patterns near death. To examine how the informal care relationship affects hospice use patterns. DATA SOURCES: Medicare Current Beneficiary Survey (MCBS), 1997-2001. STUDY DESIGN: Using logistic regression and ordinary least squares, we examine the association between a person's in-home network of care and the use of Medicare hospice services in the last year of life. We also examine whether the care-dyad relationship is associated with different hospice use patterns. DATA EXTRACTION: All individuals in the MCBS who lived at home at the time of the interview and who died between 1998 and 2001, 1404 persons. PRINCIPAL FINDINGS: People receiving formal home care had a much higher chance of enrolling in hospice prior to death. Informal care did not influence the likelihood of hospice but was associated with longer use among hospice users. Daughter caregivers increased the likelihood and duration of hospice use whereas sons significantly decreased the likelihood. CONCLUSIONS: Because formal care is associated with increased use of hospice, future work should examine whether patients without an in-home network faced access barriers. Caregiver relationships had large effects on length of hospice stays, yet we do not know whether changes moved a patient closer to or further away from their optimum use of the benefit.

Authors
Van Houtven, CH; Taylor, DH; Steinhauser, K; Tulsky, JA
MLA Citation
Van Houtven, CH, Taylor, DH, Steinhauser, K, and Tulsky, JA. "Is a home-care network necessary to access the Medicare hospice benefit?." J Palliat Med 12.8 (August 2009): 687-694.
PMID
19591625
Source
pubmed
Published In
Journal of Palliative Medicine
Volume
12
Issue
8
Publish Date
2009
Start Page
687
End Page
694
DOI
10.1089/jpm.2008.0255

The effect of hospice on Medicare and informal care costs: the U.S. Experience.

The effect of hospice on third-party payer costs has long been of great interest in the United States and other nations. The choice of hospice could also influence the costs experienced by patients and family members as compared with when Medicare beneficiaries choose to use normal care. This article considers both types of cost in the context of the United States. Hospice provides a rare example of a medical or multiprofessional intervention that improves quality of life for patients while reducing the costs of third-party insurers. Out-of-pocket costs do not differ by hospice use, but families experience higher informal costs when a loved one who is dying uses hospice. There are likely benefits of such interactions that would offset any costs, but these are hard to quantify. The Medicare program is supposed to provide necessary and reasonable care to beneficiaries, and hospice would easily pass any such assessment.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "The effect of hospice on Medicare and informal care costs: the U.S. Experience." J Pain Symptom Manage 38.1 (July 2009): 110-114.
PMID
19615635
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
38
Issue
1
Publish Date
2009
Start Page
110
End Page
114
DOI
10.1016/j.jpainsymman.2009.04.003

The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited.

Our study estimates the sensitivity and specificity of Medicare claims to identify clinically-diagnosed dementia, and documents how errors in dementia assessment affect dementia cost estimates. We compared Medicare claims from 1993-2005 to clinical dementia assessments carried out in 2001-2003 for the Aging Demographics and Memory Study (ADAMS) cohort (n = 758) of the Health and Retirement Study. The sensitivity and specificity of Medicare claims was 0.85 and 0.89 for dementia (0.64 and 0.95 for AD). Persons with dementia cost the Medicare program (in 2003) $7,135 more than controls (P < 0.001) when using claims to identify dementia, compared to $5,684 more when using ADAMS (P < 0.001). Using Medicare claims to identify dementia results in a 110% increase in costs for those with dementia as compared to a 68% increase when using ADAMS to identify disease, net of other variables. Persons with false positive Medicare claims notations of dementia were the most expensive group of subjects ($11,294 versus $4,065, for true negatives P < 0.001). Medicare claims overcount the true prevalence of dementia, but there are both false positive and negative assessments of disease. The use of Medicare claims to identify dementia results in an overstatement of the increase in Medicare costs that are due to dementia.

Authors
Taylor, DH; Østbye, T; Langa, KM; Weir, D; Plassman, BL
MLA Citation
Taylor, DH, Østbye, T, Langa, KM, Weir, D, and Plassman, BL. "The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited." J Alzheimers Dis 17.4 (2009): 807-815.
PMID
19542620
Source
pubmed
Published In
Journal of Alzheimer's disease : JAD
Volume
17
Issue
4
Publish Date
2009
Start Page
807
End Page
815
DOI
10.3233/JAD-2009-1099

Duke wants scholarship to rival Morehead

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Duke wants scholarship to rival Morehead." (December 2008).
Source
manual
Publish Date
2008

Duke wants scholarship to rival Morehead

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Duke wants scholarship to rival Morehead." (December 2008).
Source
manual
Publish Date
2008

Trajectories of caregiving time provided by wives to their husbands with dementia.

Spouses are often the first providers of informal care when their partners develop dementia. We used The National Longitudinal Caregiver Study (NLCS, 4 annual surveys, 1999 to 2002) and identified 3 distinct longitudinal patterns (trajectory classes) of total daily caregiving time provided by the wife to her husband using Generalized growth mixture models (GGMM). About 56.4% of the sample (N=828) was found to have an increase in the trajectory of total daily caregiving time (mean 252 min/d at baseline, rising to 471 min/d at time 4). Four hundred forty-four (30.3%) caregivers had a trajectory described by a moderate increase in caregiving time (an increase from a mean of 464 min/d at baseline to 533 at wave 4), whereas 195 (13.3%) had a sharply declining trajectory (a decline from a mean of 719 min/d at baseline to 421 at wave 4). There was no significant difference in the duration (time since onset) of caregiving at baseline for these 3 trajectories. GGMM are well suited for the identification of distinct trajectory classes. Here they show that there are large differences in caregiving time provided to persons with dementia, who seem to be quite similar.

Authors
Taylor, DH; Kuchibhatla, M; Østbye, T
MLA Citation
Taylor, DH, Kuchibhatla, M, and Østbye, T. "Trajectories of caregiving time provided by wives to their husbands with dementia." Alzheimer Dis Assoc Disord 22.2 (April 2008): 131-136.
PMID
18525284
Source
pubmed
Published In
Alzheimer Disease and Associated Disorders
Volume
22
Issue
2
Publish Date
2008
Start Page
131
End Page
136
DOI
10.1097/WAD.0b013e31815bebba

Identifying trajectories of depressive symptoms for women caring for their husbands with dementia.

OBJECTIVES: To use an innovative statistical method, Latent Class Trajectory Analysis (LCTA), to identify and describe subgroups (called trajectories) of caregiver depressive symptoms in a national sample of wives providing informal care for their husbands with dementia. DESIGN: Longitudinal. SETTING: Community. PARTICIPANTS: Respondents to the National Longitudinal Caregiver Survey were wife caregivers of veterans with dementia who were identified through Veterans Affairs hospitals nationally. MEASUREMENTS: Mean number of depressive symptoms as measured using the Center for Epidemiologic Studies Depression scale (CES-D, 20-item scale). RESULTS: Overall mean depressive symptoms of wife caregivers were 6.2 of 20, below the cutpoint (8 or 9/20) associated with clinical depression. Four distinct trajectories of caregiver depressive symptoms were identified. The trajectory with the highest number of symptoms (11.9 of 20), contained one-third of the sample. Another third had mean depressive symptoms virtually identical to the overall sample mean. The final third were divided between two trajectories, low depressive symptoms (mean CES-D, 3.0/20, 22% of sample) and very low (mean CES-D, 0.8/20, 14% of sample). Approximately two-thirds of the sample members were in a depressive symptom trajectory, with substantially higher or lower numbers of symptoms than the overall mean. Two subjective measures asked of wife caregivers (desire for more help, life satisfaction) were significantly associated with membership in the highest depressive symptom trajectory. CONCLUSION: LCTA identified important depressive symptom subgroups of wife caregivers. A population-averaging method identified a mean effect that was similar to the effect in one-third of the cases but substantially different from that in two-thirds of the cases.

Authors
Taylor, DH; Ezell, M; Kuchibhatla, M; Østbye, T; Clipp, EC
MLA Citation
Taylor, DH, Ezell, M, Kuchibhatla, M, Østbye, T, and Clipp, EC. "Identifying trajectories of depressive symptoms for women caring for their husbands with dementia." J Am Geriatr Soc 56.2 (February 2008): 322-327.
PMID
18179488
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
56
Issue
2
Publish Date
2008
Start Page
322
End Page
327
DOI
10.1111/j.1532-5415.2007.01558.x

Identification of dementia: agreement among national survey data, medicare claims, and death certificates.

OBJECTIVE: To estimate the proportion of seniors with dementia from three independent data sources and their agreement. DATA SOURCES: The longitudinal Asset and Health Dynamics among the Oldest Old (AHEAD) study (n=7,974), Medicare claims, and death certificate data. STUDY DESIGN: Estimates of the proportion of individuals with dementia from: (1) self- or proxy-reported cognitive status measures from surveys, (2) Medicare claims, and (3) death certificates. Agreement using Cohen's kappa; multivariate logistic regression. PRINCIPAL FINDINGS: The proportion varied substantially among the data sources. Agreement was poor (kappa: 0.14-0.46 depending upon comparison assessed); the individuals identified had relatively modest overlap. CONCLUSIONS: Estimates of dementia occurrence based on cognitive status measures from three independent data sources were not interchangeable. Further validation of these sources is needed. Caution should be used if policy is based on only one data source.

Authors
Ostbye, T; Taylor, DH; Clipp, EC; Scoyoc, LV; Plassman, BL
MLA Citation
Ostbye, T, Taylor, DH, Clipp, EC, Scoyoc, LV, and Plassman, BL. "Identification of dementia: agreement among national survey data, medicare claims, and death certificates." Health Serv Res 43.1 Pt 1 (February 2008): 313-326.
PMID
18211532
Source
pubmed
Published In
Health Services Research
Volume
43
Issue
1 Pt 1
Publish Date
2008
Start Page
313
End Page
326
DOI
10.1111/j.1475-6773.2007.00748.x

Characterizing hospice discharge patterns in a nationally representative sample of the elderly, 1993-2000.

The aim of this study is to identify the prevalence and correlates of individuals discharged alive from hospice in the Medicare program to determine whether the current hospice benefit matches the needs of dying patients. Using a nationally representative sample of age-eligible Medicare beneficiaries who died from 1993 to 2000, the use of hospice and other Medicare-financed care was analyzed during the last year of life for different groups of hospice users. It was found that 84.5% (n = 1029) of hospice users initiate and use it continuously until death; 15.5% of hospice users are discharged alive, with some later reinitiating hospice. The main difference between continuous hospice users and those discharged alive is the time survived after initial hospice use (those discharged alive live longer). After controlling for survival time, costs per day survived are similar for all groups. This study suggests several motivations for being discharged alive that are worthy of more research.

Authors
Taylor, DH; Steinhauser, K; Tulsky, JA; Rattliff, J; Van Houtven, CH
MLA Citation
Taylor, DH, Steinhauser, K, Tulsky, JA, Rattliff, J, and Van Houtven, CH. "Characterizing hospice discharge patterns in a nationally representative sample of the elderly, 1993-2000." Am J Hosp Palliat Care 25.1 (February 2008): 9-15.
PMID
18198361
Source
pubmed
Published In
American Journal of Hospice & Palliative Medicine
Volume
25
Issue
1
Publish Date
2008
Start Page
9
End Page
15
DOI
10.1177/1049909107310136

"Hospice Saves Medicare Money

Authors
Taylor, DH
MLA Citation
Taylor, DH. ""Hospice Saves Medicare Money." (January 2008).
Source
manual
Publish Date
2008

The Cost of Aging in N.C.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "The Cost of Aging in N.C." North Carolina Public Radio News (January 2008).
Source
manual
Published In
North Carolina Public Radio News
Publish Date
2008

The effect of spousal caregiving and bereavement on depressive symptoms.

The objective of the study was to determine whether spousal caregiving and bereavement increases caregiver depressive symptoms. We followed 1,967 community-dwelling elderly couples from the 1993 Health and Retirement Study (HRS) until 2002 (five bi-annual surveys) or death. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CESD) scale. Adjusted depressive symptoms were higher for females for three of the four caregiving arrangements tested (as were unadjusted baseline levels). Depressive symptoms were lowest when neither spouse received caregiving (adjusted CESD of 2.97 for males; 3.44 for females, p<0.001). They were highest when females provided care to their husband with assistance from another caregiver, (4.01) compared to (3.37; p<0.001) when males so cared for their wife. A gender by caregiving arrangements interaction was not significant (p=0.13), showing no differential effect of caregiving on CESD by gender. Depressive symptoms peaked for bereaved spouses within three months of spousal death (4.67; p<0.001) but declined steadily to 2.75 (p<0.001) more than 15 months after death. Depressive symptoms initially increased for the community spouse after institutionalization of the care recipient, but later declined. We conclude that caregiving increases depressive symptoms in the caregiver, but does not have a differential effect by gender. Increases in depressive symptoms following bereavement are short-term.

Authors
Taylor, DH; Kuchibhatla, M; Ostbye, T; Plassman, BL; Clipp, EC
MLA Citation
Taylor, DH, Kuchibhatla, M, Ostbye, T, Plassman, BL, and Clipp, EC. "The effect of spousal caregiving and bereavement on depressive symptoms." Aging Ment Health 12.1 (January 2008): 100-107.
PMID
18297484
Source
pubmed
Published In
Aging & Mental Health
Volume
12
Issue
1
Publish Date
2008
Start Page
100
End Page
107
DOI
10.1080/13607860801936631

Honoring by saving

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Honoring by saving." Raleigh, (NC), News and Observer (2008).
Source
manual
Published In
Raleigh, (NC), News and Observer
Publish Date
2008

The accidental system: private and public actions to provide long term care

Authors
Taylor, DH
MLA Citation
Taylor, DH. "The accidental system: private and public actions to provide long term care." North Carolina Insight (2008). (Editorial Comment)
Source
manual
Published In
North Carolina Insight
Publish Date
2008

Puffing away your paycheck–the cost of smoking

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Puffing away your paycheck–the cost of smoking." (2008).
Source
manual
Publish Date
2008

What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program?

Hospices have been expected to reduce health expenditures since their addition to the US Medicare benefit package in the early-1980s, but the literature on their ability to do so is mixed. The contradictory findings noted in previous studies may be due to selection bias and the period of cost comparison used. Accounting for these, this study focuses on the length of hospice use that maximizes reductions in medical expenditures near death. We used a retrospective, case/control study of Medicare decedents (1993-2003, National Long Term Care Survey screening sample) to compare 1819 hospice decedents, with 3638 controls matched via their predicted likelihood of dying while using a hospice. Variables used to create matches were demographic, primary medical condition, cost of Medicare financed care prior to the last year of life, nursing home residence and Medicaid eligibility. Hospice use reduced Medicare program expenditures during the last year of life by an average of $2309 per hospice user; expenditures after initiation of hospice were $7318 for hospice users compared to $9627 for controls (P<0.001). On average, hospice use reduced Medicare expenditures during all but 2 of hospice users' last 72 days of life; about $10 on the 72nd day prior to death, with savings increasing to more than $750 on the day of death. Maximum cumulative expenditure reductions differed by primary condition. The maximum reduction in Medicare expenditures per user was about $7000, which occurred when a decedent had a primary condition of cancer and used a hospice for their last 58-103 days of life. For other primary conditions, the maximum savings of around $3500 occurred when a hospice was used for the last 50-108 days of life. Given the length of hospice use observed in the Medicare program, increasing the length of hospice use for 7 in 10 Medicare hospice users would increase savings.

Authors
Taylor, DH; Ostermann, J; Van Houtven, CH; Tulsky, JA; Steinhauser, K
MLA Citation
Taylor, DH, Ostermann, J, Van Houtven, CH, Tulsky, JA, and Steinhauser, K. "What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program?." Soc Sci Med 65.7 (October 2007): 1466-1478.
PMID
17600605
Source
pubmed
Published In
Social Science & Medicine
Volume
65
Issue
7
Publish Date
2007
Start Page
1466
End Page
1478
DOI
10.1016/j.socscimed.2007.05.028

Designating places and populations as medically underserved: a proposal for a new approach.

This article describes the development of a theory-based, data-driven replacement for the Health Professional Shortage Area (HPSA) and Medically Underserved Area (MUA) designation systems. Data describing utilization of primary medical care and the distribution of practitioners were used to develop estimates of the effects of demographic and community characteristics on use of primary medical care. A scoring system was developed that estimates each community's effective access to primary care. This approach was reviewed and contributed to by stakeholder groups. The proposed formula would designate over 90% of current geographic and low-income population HPSA designations. The scalability of the method allows for adjustment for local variations in need and was considered acceptable by stakeholder groups. A data-driven, theory-based metric to calculate relative need for geographic areas and geographically-bounded special populations can be developed and used. Its use, however, requires careful explanation to and support from affected groups.

Authors
Ricketts, TC; Goldsmith, LJ; Holmes, GM; Randolph, RMRP; Lee, R; Taylor, DH; Ostermann, J
MLA Citation
Ricketts, TC, Goldsmith, LJ, Holmes, GM, Randolph, RMRP, Lee, R, Taylor, DH, and Ostermann, J. "Designating places and populations as medically underserved: a proposal for a new approach." J Health Care Poor Underserved 18.3 (August 2007): 567-589.
PMID
17675714
Source
pubmed
Published In
Journal of Health Care for the Poor and Underserved
Volume
18
Issue
3
Publish Date
2007
Start Page
567
End Page
589
DOI
10.1353/hpu.2007.0065

Trajectories of caregiving time provided by wives to their husband’s with dementia

Authors
Taylor, DH; Kuchibhatla, M; Ostbye, T
MLA Citation
Taylor, DH, Kuchibhatla, M, and Ostbye, T. "Trajectories of caregiving time provided by wives to their husband’s with dementia." Forthcoming in Alzheimer’s Disease and Associated Disorders (2007). (Academic Article)
Source
manual
Published In
Forthcoming in Alzheimer’s Disease and Associated Disorders
Publish Date
2007

Identification of dementia: agreement among national survey data, Medicare claims and death certificates

Authors
T Østbye, DHT; Plassman, B
MLA Citation
T Østbye, DHT, and Plassman, B. "Identification of dementia: agreement among national survey data, Medicare claims and death certificates." Forthcoming in Health Services Research (2007). (Academic Article)
Source
manual
Published In
Forthcoming in Health Services Research
Publish Date
2007

Characterizing hospice discharge patterns in a nationally representative sample of the elderly, 1993-2000

Authors
Taylor, DH; Houtwen, CHV; Steinhauser, K; Tulsky, J
MLA Citation
Taylor, DH, Houtwen, CHV, Steinhauser, K, and Tulsky, J. "Characterizing hospice discharge patterns in a nationally representative sample of the elderly, 1993-2000." Forthcoming in American Journal of Hospice and Palliative Medicine (2007). (Academic Article)
Source
manual
Published In
Forthcoming in American Journal of Hospice and Palliative Medicine
Publish Date
2007

The effect of spousal caregiving and bereavement on depressive symptoms

Authors
Taylor, DH; Kuchibhatla, M; Ostbye, T; Plassman, B; Clipp, E
MLA Citation
Taylor, DH, Kuchibhatla, M, Ostbye, T, Plassman, B, and Clipp, E. "The effect of spousal caregiving and bereavement on depressive symptoms." Forthcoming in Journal of Hospice and Palliative Medicine (2007). (Academic Article)
Source
manual
Published In
Forthcoming in Journal of Hospice and Palliative Medicine
Publish Date
2007

The accidental system: private and public actions to provide long term care.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "The accidental system: private and public actions to provide long term care." Forthcoming in N.C. Insight (2007). (Academic Article)
Source
manual
Published In
Forthcoming in N.C. Insight
Publish Date
2007

The Price of Smoking

What does a pack of cigarettes cost a smoker, the smoker's family, and society? This longitudinal study on the private and social costs of smoking calculates that the cost of smoking to a 24-year-old woman smoker is $86,000 over a lifetime; for a 24-year-old male smoker the cost is $183,000. The total social cost of smoking over a lifetime—including both private costs to the smoker and costs imposed on others (including second-hand smoke and costs of Medicare, Medicaid, and Social Security)—comes to $106,000 for a woman and $220,000 for a man. The cost per pack over a lifetime of smoking: almost $40.00. The first study to quantify the cost of smoking in this way, or in such depth, this accessible book not only adds a weapon to the arsenal of antismoking messages but also provides a framework for assessment that can be applied to other health behaviors. The findings on the effects of smoking on Medicare and Medicaid will be surprising and perhaps controversial, for the authors estimate the costs to be much lower than the damage awards being paid to 46 states as a result of the 1998 Master Settlement Agreement.

Authors
Sloan, FA; Ostermann, J; Conover, C; Donald H Taylor, J; Picone, G
MLA Citation
Sloan, FA, Ostermann, J, Conover, C, Donald H Taylor, J, and Picone, G. The Price of Smoking. September 2006.
Source
repec
Volume
1
Publish Date
2006

Access to health care services for the disabled elderly.

To determine whether difficulty walking and the strategies persons use to compensate for this deficit influenced downstream Medicare expenditures.Secondary data analysis of Medicare claims data (1999-2000) for age-eligible Medicare beneficiaries (N=4,997) responding to the community portion of the 1999 National Long Term Care Survey (NLTCS).Longitudinal cohort study. Walking difficulty and compensatory strategy were measured at the 1999 NLTCS, and used to predict health care use as measured in Medicare claims data from the survey date through year-end 2000.Respondents to the 1999 community NLTCS with complete information on key explanatory variables (walking difficulty and compensatory strategy) were linked with Medicare claims to define outcome variables (health care use and cost).Persons who reported it was very difficult to walk had more downstream home health visits (1.1/month, p<.001), but fewer outpatient physician visits (-0.16/month, p<.001) after controlling for overall disease burden. Those using a compensatory strategy for walking also had increased home health visits/month (0.55 for equipment, 1.0 for personal assistance, p<.001 for both) but did not have significantly reduced outpatient visits. Persons reporting difficulty walking had increased downstream Medicare costs ranging from 163 US dollars to 222 US dollars/month (p<.001) depending upon how difficult walking was. Less than half of the persons who used equipment to adapt to walking difficulty had their difficulty fully compensated by the use of equipment. Persons using equipment that fully compensated their difficulty used around 300 US dollars/month less in Medicare-financed costs compared with those with residual difficulty.Difficulty walking and use of compensatory strategies are correlated with the use of Medicare-financed services. The potential impact on the Medicare program is large, given how common such limitations are among the elderly.

Authors
Taylor, DH; Hoenig, H
MLA Citation
Taylor, DH, and Hoenig, H. "Access to health care services for the disabled elderly." Health services research 41.3 Pt 1 (June 2006): 743-758.
Source
epmc
Published In
Health Services Research
Volume
41
Issue
3 Pt 1
Publish Date
2006
Start Page
743
End Page
758
DOI
10.1111/j.1475-6773.2006.00509.x

Access to health care services for the disabled elderly.

OBJECTIVE: To determine whether difficulty walking and the strategies persons use to compensate for this deficit influenced downstream Medicare expenditures. DATA SOURCE: Secondary data analysis of Medicare claims data (1999-2000) for age-eligible Medicare beneficiaries (N=4,997) responding to the community portion of the 1999 National Long Term Care Survey (NLTCS). STUDY DESIGN: Longitudinal cohort study. Walking difficulty and compensatory strategy were measured at the 1999 NLTCS, and used to predict health care use as measured in Medicare claims data from the survey date through year-end 2000. DATA EXTRACTION: Respondents to the 1999 community NLTCS with complete information on key explanatory variables (walking difficulty and compensatory strategy) were linked with Medicare claims to define outcome variables (health care use and cost). PRINCIPAL FINDINGS: Persons who reported it was very difficult to walk had more downstream home health visits (1.1/month, p<.001), but fewer outpatient physician visits (-0.16/month, p<.001) after controlling for overall disease burden. Those using a compensatory strategy for walking also had increased home health visits/month (0.55 for equipment, 1.0 for personal assistance, p<.001 for both) but did not have significantly reduced outpatient visits. Persons reporting difficulty walking had increased downstream Medicare costs ranging from 163 US dollars to 222 US dollars/month (p<.001) depending upon how difficult walking was. Less than half of the persons who used equipment to adapt to walking difficulty had their difficulty fully compensated by the use of equipment. Persons using equipment that fully compensated their difficulty used around 300 US dollars/month less in Medicare-financed costs compared with those with residual difficulty. CONCLUSIONS: Difficulty walking and use of compensatory strategies are correlated with the use of Medicare-financed services. The potential impact on the Medicare program is large, given how common such limitations are among the elderly.

Authors
Taylor, DH; Hoenig, H
MLA Citation
Taylor, DH, and Hoenig, H. "Access to health care services for the disabled elderly." Health Serv Res 41.3 Pt 1 (June 2006): 743-758.
PMID
16704510
Source
pubmed
Published In
Health Services Research
Volume
41
Issue
3 Pt 1
Publish Date
2006
Start Page
743
End Page
758
DOI
10.1111/j.1475-6773.2006.00509.x

Lower extremity physical performance and use of compensatory strategies for mobility.

OBJECTIVES: To compare measured lower extremity physical performance in the clinic with the methods used to carry out mobility tasks at home and to identify key factors influencing day-to-day task performance. DESIGN: Cross-sectional analysis of the Women's Health and Aging Study I. SETTING: Community-dwelling female residents of Baltimore, Maryland. PARTICIPANTS: One thousand two cognitively intact women aged 65 and older with moderate to severe physical limitations. MEASUREMENTS: Compensatory strategies reportedly used for mobility in the home, distinguishing between use of no compensatory strategies, behavioral changes only, durable medical equipment (DME) with or without behavioral change, and human help; measured lower extremity (LE) physical performance (gait speed, timed chair stands, balance). RESULTS: There was a statistically significant difference in LE physical performance between women using the four types of compensatory strategy (P < .001). Women who used DME for mobility in the home had worse performance than those using human help who in turn had worse performance than those with behavioral changes only; women reporting no compensatory strategies for in-home mobility performed best. Sequential multivariate logistic regressions identified several factors other than LE physical performance that were associated with use of specific compensatory strategies. Medical conditions, education, and environmental barriers influenced whether compensatory strategies were used at all, whereas income, contact with health providers, and availability of help in the home influenced the type of compensatory strategy. CONCLUSION: Physical abilities are an important factor influencing use of compensatory strategies for mobility, but several other factors also influence the ways that women adapt to mobility limitations.

Authors
Hoenig, H; Ganesh, SP; Taylor, DH; Pieper, C; Guralnik, J; Fried, LP
MLA Citation
Hoenig, H, Ganesh, SP, Taylor, DH, Pieper, C, Guralnik, J, and Fried, LP. "Lower extremity physical performance and use of compensatory strategies for mobility." J Am Geriatr Soc 54.2 (February 2006): 262-269.
PMID
16460377
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
54
Issue
2
Publish Date
2006
Start Page
262
End Page
269
DOI
10.1111/j.1532-5415.2005.00588.x

Designating Places and Populations as Medically Underserved: A Proposal for a New Approach

Authors
Ricketts, TC; Goldsmith, LJ; Holmes, M; Randolph, R; Lee, R; Taylor, DH
MLA Citation
Ricketts, TC, Goldsmith, LJ, Holmes, M, Randolph, R, Lee, R, and Taylor, DH. "Designating Places and Populations as Medically Underserved: A Proposal for a New Approach." Journal of Health Care for the Poor and Underserved (2006). (Academic Article)
Source
manual
Published In
Journal of Health Care for the Poor and Underserved
Publish Date
2006

A Condemned Man’s DNA Appeal

Authors
Taylor, DH
MLA Citation
Taylor, DH. "A Condemned Man’s DNA Appeal." (2006).
Source
manual
Publish Date
2006

Heavy alcohol use and marital dissolution in the USA.

Using the first five waves of the US Health and Retirement Study, a nationally representative survey of middle-aged persons in the USA conducted between 1992 and 2000, we assessed the association between alcohol consumption and separation and divorce (combined as divorced in the analysis) for 4589 married couples during up to four repeated 2-yr follow-up periods. We found that drinking status was positively correlated between spouses. The correlations did not increase over the follow-up period. Discrepancies in alcohol consumption between spouses were more closely related to the probability of subsequent divorce than consumption levels per se. Couples with two abstainers and couples with two heavy drinkers had the lowest rates of divorce. Couples with one heavy drinker were most likely to divorce. Controlling for current consumption levels, a history of problem drinking by either spouse was not significantly associated with an increased probability of divorce. Our findings on alcohol use and marital dissolution were highly robust in alternative specifications.

Authors
Ostermann, J; Sloan, FA; Taylor, DH
MLA Citation
Ostermann, J, Sloan, FA, and Taylor, DH. "Heavy alcohol use and marital dissolution in the USA." Soc Sci Med 61.11 (December 2005): 2304-2316.
PMID
16139939
Source
pubmed
Published In
Social Science & Medicine
Volume
61
Issue
11
Publish Date
2005
Start Page
2304
End Page
2316
DOI
10.1016/j.socscimed.2005.07.021

Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study.

OBJECTIVES: Obese Americans, who receive more care for chronic diseases, may receive fewer preventive services. We evaluated the association between body mass index (BMI) and receipt of screening mammography and Papanicolaou tests among middle-aged women and the association between BMI and receipt of influenza vaccination among the elderly. METHODS: We analyzed 2 datasets: the Health and Retirement Study (4439 women aged 50-61 years) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study (4045 women and 2154 men aged 70 years or more). RESULTS: When BMI was greater than 18.5 kg/m2, we found an inverse dose-response relationship between BMI and receipt of screening mammography and Pap tests among White, but not Black, middle-aged women. We found a similar association between BMI and influenza vaccination among the elderly. CONCLUSIONS: Higher BMI was associated with less frequent receipt of preventive services among middle-aged White women and elderly White women and men. The Healthy People 2010 clinical preventive service goals remain elusive, especially for overweight and obese White persons.

Authors
Østbye, T; Taylor, DH; Yancy, WS; Krause, KM
MLA Citation
Østbye, T, Taylor, DH, Yancy, WS, and Krause, KM. "Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study." Am J Public Health 95.9 (September 2005): 1623-1630.
PMID
16051935
Source
pubmed
Published In
American journal of public health
Volume
95
Issue
9
Publish Date
2005
Start Page
1623
End Page
1630
DOI
10.2105/AJPH.2004.047803

The impact of own and spouse's urinary incontinence on depressive symptoms.

This study investigated the impact of own and spouse's urinary incontinence on depressive symptoms. Attention was paid to the possibility that gender and caregiving might be important factors in understanding significant effects. We used negative binomial regression to analyze survey data for 9974 middle-aged and older respondents to the Health and Retirement Study in the USA. Results supported the hypothesis that the respondents' own urinary incontinence was associated with depressive symptoms (unadj. IRR = 1.73, 95% CIs = 1.53, 1.95 for men; unadj. IRR = 1.50, 95% CIs = 1.38, 1.63 for women). Controlling sociodemographic and health variables reduced this relationship, but it remained statistically significant for both men and women. Having an incontinent wife put men at greater risk for depressive symptoms (unadj. IRR = 1.13, 95% CIs = 1.02, 1.25), although this relation became nonsignificant with the addition of control variables. No relation between women's depressive symptoms and husbands' (in)continence status was found. Caregiving was not a significant variable in the adjusted analyses, but spouses' depressive symptoms emerged as a significant predictor of the respondents' own depressive symptoms. Health care providers must be sensitive to the emotional impact of urinary incontinence. Our findings also suggest the importance of considering the patient's mental health within a wider context, particularly including the physical and mental health of the patient's spouse.

Authors
Fultz, NH; Rahrig Jenkins, K; Østbye, T; Taylor, DH; Kabeto, MU; Langa, KM
MLA Citation
Fultz, NH, Rahrig Jenkins, K, Østbye, T, Taylor, DH, Kabeto, MU, and Langa, KM. "The impact of own and spouse's urinary incontinence on depressive symptoms." Soc Sci Med 60.11 (June 2005): 2537-2548.
PMID
15814179
Source
pubmed
Published In
Social Science & Medicine
Volume
60
Issue
11
Publish Date
2005
Start Page
2537
End Page
2548
DOI
10.1016/j.socscimed.2004.11.019

Do seniors understand their risk of moving to a nursing home?

OBJECTIVE: To determine whether seniors understand their risk of moving to a nursing home. Data Sources. We used longitudinal data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) database. AHEAD is a nationally representative survey (n=8,203) of community dwellers aged 70+ years and their spouses. STUDY DESIGN: We followed respondents for 5 years from the date of the first interview fielded in 1993. Our primary dependent variable was whether respondents moved to a nursing home within 5 years of baseline; self-assessed probability of moving to a nursing home within 5 years, also assessed at baseline, was the primary explanatory variable. PRINCIPAL FINDINGS: We found that seniors who believed they were more likely to move to a nursing home within 5 years were indeed more likely to do so, and that most elders overestimated their likelihood of moving to a nursing home. CONCLUSIONS: Low rates of private long-term care insurance are not plausibly a result of seniors underestimating their personal risk of moving to a nursing home; such an assumption is inherent in many strategies to plan for the future long-term care needs of the baby boom generation.

Authors
Taylor, DH; Osterman, J; Will Acuff, S; Ostbye, T
MLA Citation
Taylor, DH, Osterman, J, Will Acuff, S, and Ostbye, T. "Do seniors understand their risk of moving to a nursing home?." Health Serv Res 40.3 (June 2005): 811-828.
PMID
15960692
Source
pubmed
Published In
Health Services Research
Volume
40
Issue
3
Publish Date
2005
Start Page
811
End Page
828
DOI
10.1111/j.1475-6773.2005.00386.x

Alzheimer's disease and the family caregiver: the cost and who pays?

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Alzheimer's disease and the family caregiver: the cost and who pays?." N C Med J 66.1 (January 2005): 16-23. (Review)
PMID
15786673
Source
pubmed
Published In
North Carolina Medical Journal
Volume
66
Issue
1
Publish Date
2005
Start Page
16
End Page
23

Equal division of estates and the exchange motive

Although the bequest motive is one of the most important theoretical extensions of the life-cycle hypothesis, few empirical studies have measured determinants of unequal estate division. We estimated whether several proxies that are consistent with exchange and altruism lead to unequal estate division using data from a longitudinal survey of deceased elderly persons linked to probate court records. Equal division was the rule-between 70 and 83% of estates were divided equally, depending on the strictness of the definition of equal division. Several measures of exchange were not significant predictors of unequal division. Two factors that are consistent with both exchange and altruism-writing the last will and testament within five years of death and having more children-predict unequal estate division. The models control for selection, because many decedents do not file a record in probate court. © 2005 by The Haworth Press, Inc. All rights reserved.

Authors
Norton, EC; Jr, DHT
MLA Citation
Norton, EC, and Jr, DHT. "Equal division of estates and the exchange motive." Journal of Aging and Social Policy 17.1 (2005): 63-82.
PMID
15760801
Source
scival
Published In
Journal of Aging and Social Policy
Volume
17
Issue
1
Publish Date
2005
Start Page
63
End Page
82
DOI
10.1300/J031v17n01_04

Comorbid illness affects hospital costs related to hip arthroplasty: quantification of health status and implications for fair reimbursement and surgeon comparisons.

Optimized resource allocation, reimbursement negotiations, and provider comparisons hinge on an understanding of the drivers of healthcare costs. Indices of comorbid illness may be useful for stratifying patients based on cost. Total hospital cost was analyzed for 1 surgeon's hip arthroplasty patients (June 1998-March 2001). Three scales of health status were selected as independent predictors. One thousand ninety-two hip arthroplasty inpatient stays were evaluated. The median total hospital cost was 14,011 dollars. An increasing burden of comorbid illness as measured by the All Patient Refined Diagnosis Related Group Severity of Illness scale and the modified Charlson Comorbidity Index was significantly associated with increasing hospital cost. Comorbid illness is associated with cost; scales may be used to stratify patients based on risk of high cost care.

Authors
Shah, AN; Vail, TP; Taylor, D; Pietrobon, R
MLA Citation
Shah, AN, Vail, TP, Taylor, D, and Pietrobon, R. "Comorbid illness affects hospital costs related to hip arthroplasty: quantification of health status and implications for fair reimbursement and surgeon comparisons." J Arthroplasty 19.6 (September 2004): 700-705.
PMID
15343528
Source
pubmed
Published In
Journal of Arthroplasty
Volume
19
Issue
6
Publish Date
2004
Start Page
700
End Page
705

Marked increase in Alzheimer's disease identified in medicare claims records between 1991 and 1999.

BACKGROUND: Epidemiologic evidence suggests that African Americans have higher rates of Alzheimer's disease (AD) than do whites. Examining longitudinal trends in the number of persons who are identified as having AD in administrative databases may provide insights into this phenomenon. METHODS: We analyzed 9-year longitudinal data (1991-1999) for 29,679 Medicare beneficiaries who were screened for the National Long-Term Care Survey. Cases of AD were identified using ICD-9-CM diagnosis codes from Medicare claims files. RESULTS: Age-adjusted rates of Medicare beneficiaries identified as having AD rose from 1991-1999 for all groups studied, but particularly among African Americans. In 1991, African Americans made up 6.5% of the identified AD cases but comprised 11.0% of cases in 1999 (X(2) = 6.79, p =.005). The rate of increase in identification of AD was particularly large for women who were aged 85 years and older. CONCLUSIONS: Reasons for increased identification of AD in Medicare claims is likely multifactorial; sharp increases among African Americans may reflect improved access.

Authors
Taylor, DH; Sloan, FA; Doraiswamy, PM
MLA Citation
Taylor, DH, Sloan, FA, and Doraiswamy, PM. "Marked increase in Alzheimer's disease identified in medicare claims records between 1991 and 1999." J Gerontol A Biol Sci Med Sci 59.7 (July 2004): 762-766.
PMID
15304542
Source
pubmed
Published In
Journals of Gerontology: Series A
Volume
59
Issue
7
Publish Date
2004
Start Page
762
End Page
766

Marked increase in Alzheimer's disease identified in Medicare claims records between 1991 and 1999

Authors
Doraiswamy, PM; Taylor, DH; Sloan, FA
MLA Citation
Doraiswamy, PM, Taylor, DH, and Sloan, FA. "Marked increase in Alzheimer's disease identified in Medicare claims records between 1991 and 1999." July 2004.
Source
wos-lite
Published In
Neurobiology of Aging
Volume
25
Publish Date
2004
Start Page
S303
End Page
S303
DOI
10.1016/S0197-4580(04)80995-3

Rates of diagnosis of vascular dementia over 10 years in the United States Medicare claims records

Authors
Taylor, DH; Doraiswamy, PM; Sloan, FA
MLA Citation
Taylor, DH, Doraiswamy, PM, and Sloan, FA. "Rates of diagnosis of vascular dementia over 10 years in the United States Medicare claims records." July 2004.
Source
wos-lite
Published In
Neurobiology of Aging
Volume
25
Publish Date
2004
Start Page
S484
End Page
S484
DOI
10.1016/S0197-4580(04)81599-9

The effect of smoking on years of healthy life (YHL) lost among middle-aged and older Americans.

OBJECTIVE: To estimate the effects of smoking on quality of life over time, using the Years of Healthy Life (YHL) construct. DATA SOURCES/STUDY SETTING: The Health and Retirement Study (HRS) survey (N=12,652) of persons 50 to 60 years old and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (N=8,124) of persons > or =70 years old, plus spouses regardless of age, followed from 1992/1993 to 2000. STUDY DESIGN: Years of healthy life from baseline to death were estimated. Regression models were developed with smoking as the main explanatory variable and with both YHL and years of life remaining as the outcome variables. PRINCIPAL FINDINGS: Smoking was strongly and consistently related to YHL lost. In HRS, individuals who had quit smoking at least 15 years prior to baseline had a similar number of YHL left as never smokers. CONCLUSIONS: Efforts to encourage smoking cessation should emphasize the impact of these factors on quality of life.

Authors
Østbye, T; Taylor, DH
MLA Citation
Østbye, T, and Taylor, DH. "The effect of smoking on years of healthy life (YHL) lost among middle-aged and older Americans." Health Serv Res 39.3 (June 2004): 531-552.
PMID
15149477
Source
pubmed
Published In
Health Services Research
Volume
39
Issue
3
Publish Date
2004
Start Page
531
End Page
552
DOI
10.1111/j.1475-6773.2004.00243.x

Number of children associated with obesity in middle-aged women and men: results from the health and retirement study.

OBJECTIVE: To study associations between number of children and obesity in middle-aged women and men. METHODS: In the Health and Retirement Study, a national survey of households, we tested the association between increasing number of children and obesity (body mass index [BMI] >or= 30) in 9046 middle-aged women and men (4523 couples). RESULTS: Women (n = 4523) who were obese were more frequently nonwhite, reported lower household income, were more frequently employed outside the home, were less frequently covered by health insurance, and were more frequently less educated compared with nonobese women. Men (n = 4523) who were obese were younger, were more frequently African American, and were more frequently less educated and poorer compared with nonobese men. Among women, a 7% increase in risk of obesity was noted for each additional child, adjusting for age, race, household income, work status, physical activity, tobacco use, and alcohol use. Among men, a 4% increase in risk of obesity was noted for each additional child, adjusting for the same covariates. These sex differences were not significantly different. CONCLUSIONS: Previous research has demonstrated an association between number of children and obesity among women. These results suggest a similar association among men. Public health interventions focused on obesity prevention should target both parents, especially those parents with several children.

Authors
Weng, HH; Bastian, LA; Taylor, DH; Moser, BK; Ostbye, T
MLA Citation
Weng, HH, Bastian, LA, Taylor, DH, Moser, BK, and Ostbye, T. "Number of children associated with obesity in middle-aged women and men: results from the health and retirement study." J Womens Health (Larchmt) 13.1 (January 2004): 85-91.
PMID
15006281
Source
pubmed
Published In
Journal of Women's Health
Volume
13
Issue
1
Publish Date
2004
Start Page
85
End Page
91
DOI
10.1089/154099904322836492

The effect of equipment usage and residual task difficulty on use of personal assistance, days in bed, and nursing home placement.

OBJECTIVES: To determine whether residual difficulty in functioning in spite of equipment use is linked with increased use of personal assistance. DESIGN: Longitudinal. Two waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) database were used to test the effect of residual difficulty on hours of personal assistance and bed days at Wave 1 on hours of personal assistance, bed days, and nursing home placement at Waves 1 and 2. SETTING: A nationally representative setting of community-dwelling persons aged 70 and older and their spouses, regardless of age at Wave 1 AHEAD. There was movement of some respondents into nursing homes by the Wave 2 interview. PARTICIPANTS: Respondents to the AHEAD survey, N=8,222 at Wave 1. MEASUREMENTS: The dependent variables were hours of personal assistance in the month before the AHEAD survey (Waves 1 and 2), number of days in month before the survey in which the person did not get out of bed (Waves 1 and 2), and residence in a nursing home at Wave 2. The key explanatory variable was a mutually exclusive (four category) variable that specified whether there was residual difficulty (yes/no) in indoor mobility in spite of using equipment to aid specifically with indoor mobility. The four-category variable was defined by the four categories created by a cross-tabulation of equipment use (yes/no) and difficulty with indoor mobility (yes/no). A similar four-category variable was also defined for transferring in the home. RESULTS: In cross section, equipment users with residual difficulty reported more hours of personal assistance in the case of indoor mobility impairment and were more likely to have some hours of personal assistance than those without residual difficulty with indoor mobility and transferring. Longitudinally, those with residual difficulty at Wave 1 were more likely to need some personal assistance hours at Wave 2 (odds ratio=1.67, 95% confidence interval= 1.23-2.26 for indoor mobility). For transferring, those with residual difficulty had 43 more hours of personal assistance per month (P=.001) than those for whom equipment resolved their disability. Residual disability was linked to more bed days for users of indoor mobility and transferring equipment, but it was not predictive of nursing home placement by Wave 2. CONCLUSION: Equipment for indoor mobility or transfers apparently resolves difficulty for some users of the equipment but not for others. Residual task difficulty in spite of equipment for indoor mobility and transferring is linked with worse outcomes, including increased dependency on personal assistance and more days in bed. This shows that more attention is needed to determine whether equipment prescribed is appropriate for a patient's difficulty and that follow-up assessment is crucial after equipment is prescribed.

Authors
Taylor, DH; Hoenig, H
MLA Citation
Taylor, DH, and Hoenig, H. "The effect of equipment usage and residual task difficulty on use of personal assistance, days in bed, and nursing home placement." J Am Geriatr Soc 52.1 (January 2004): 72-79.
PMID
14687318
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
52
Issue
1
Publish Date
2004
Start Page
72
End Page
79

Do the Near-Elderly Value Mortality Risks Differently from Younger Persons?

Authors
Smith, VK; Evans, MF; Kim, H; Taylor, DH
MLA Citation
Smith, VK, Evans, MF, Kim, H, and Taylor, DH. "Do the Near-Elderly Value Mortality Risks Differently from Younger Persons?." The Review of Economics and Statistics 86.1 (2004): 423-429. (Academic Article)
Source
manual
Published In
The Review of Economics and Statistics
Volume
86
Issue
1
Publish Date
2004
Start Page
423
End Page
429

Effects of risk and time preference and expected longevity on demand for medical tests

Despite their conceptual importance, the effects of time preference, expected longevity, uncertainty, and risk aversion on behavior have not been analyzed empirically. We use data from the Health and Retirement Study (HRS) to assess the role of risk and time preference, expected longevity, and education on demand for three measures used for early detection of breast and cervical cancer-regular breast self-exams, mammograms, and Pap smears. We find that individuals with a higher life expectancy and lower time preference are more likely to undergo cancer screening. Less risk averse individuals tend to be more likely to undergo testing.

Authors
Picone, G; Sloan, F; Jr, DT
MLA Citation
Picone, G, Sloan, F, and Jr, DT. "Effects of risk and time preference and expected longevity on demand for medical tests." Journal of Risk and Uncertainty 28.1 (2004): 39-53.
Source
scival
Published In
Journal of Risk and Uncertainty
Volume
28
Issue
1
Publish Date
2004
Start Page
39
End Page
53
DOI
10.1023/B:RISK.0000009435.11390.23

Marked Increase in the Diagnosed Prevalence of Alzheimer's Disease between 1991 and 1999 in the United States.

Authors
Taylor, DH; Rattliff, J; Doraiswamy, PM; Sloan, FA
MLA Citation
Taylor, DH, Rattliff, J, Doraiswamy, PM, and Sloan, FA. "Marked Increase in the Diagnosed Prevalence of Alzheimer's Disease between 1991 and 1999 in the United States." Journal of Gerontology: Medical Sciences 59 (2004): M762-M766. (Academic Article)
Source
manual
Published In
Journal of Gerontology: Medical Sciences
Volume
59
Publish Date
2004
Start Page
M762
End Page
M766.

Outcomes of states' scholarship, loan repayment, and related programs for physicians

Context: Many states attempt to entice young generalist physicians into rural and medically underserved areas with financial support-for-service programs - scholarships, service-option loans, loan repayment, direct financial incentives, and resident support programs - with little documentation of their effectiveness. Objective: The objective of this study was to assess outcomes of states' support-for-service programs as a group and to compare outcomes of the 5 program types. Design: We conducted a cross-sectional, primarily descriptive study. Participants: We studied all 69 state programs operating in 1996 that provided financial support to medical students, residents, and practicing physicians in exchange for a period of service in underserved areas; federally funded initiatives were excluded. We also surveyed 434 generalist physicians who served in 29 of these state programs and a matched comparison group of 723 nonobligated young generalist physicians. Data Collection: Information on eligible programs was collected by telephone, mail questionnaires, and from secondary sources. Obligated and nonobligated physicians were surveyed, with 80.3% and 72.8% response rates, respectively. Main Outcome Measures: Levels of socioeconomic need of communities and patients served by physicians, programs' participant service completion and retention rates, and physicians' satisfaction levels. Results: Compared with young nonobligated generalists, physicians serving obligations to state programs practiced in demonstrably needier areas and cared for more patients insured under Medicaid and uninsured (48.5% vs. 28.5%, P <0.001). Service completion rates were uniformly high for loan repayment, direct incentive, and resident-support programs (93% combined) but lower for student-targeting service-option loan (mean, 44.7%) and scholarship (mean, 66.5%) programs. State-obligated physicians were more satisfied than nonobligated physicians, and 9 of 10 indicated that they would enroll in their programs again. Obligated physicians also remained longer in their practices than nonobligated physicians (P = 0.03), with respective group retention rates of 71% versus 61% at 4 years and 55% versus 52% at 8 years. Retention rates were highest for loan repayment, direct incentive, and loan programs. Conclusions: States' support-for-service programs bring physicians to needy communities where a strong majority work happily and with at-risk patient populations; half stay over 8 years. Loan repayment and direct financial incentive programs demonstrate the broadest successes. Copyright © 2004 by Lippincott Williams & Wilkins.

Authors
Pathman, DE; Konrad, TR; King, TS; Jr, DHT; Koch, GG
MLA Citation
Pathman, DE, Konrad, TR, King, TS, Jr, DHT, and Koch, GG. "Outcomes of states' scholarship, loan repayment, and related programs for physicians." Medical Care 42.6 (2004): 560-568.
PMID
15167324
Source
scival
Published In
Medical Care
Volume
42
Issue
6
Publish Date
2004
Start Page
560
End Page
568
DOI
10.1097/01.mlr.0000128003.81622.ef

The Effect of Smoking on Years of Healthy Life (YHL) Lost Among Middle Aged and Older Americans

Authors
Truls, ; 216stbye, ; Taylor, DH
MLA Citation
Truls, , 216stbye, , and Taylor, DH. "The Effect of Smoking on Years of Healthy Life (YHL) Lost Among Middle Aged and Older Americans." Health Services Research 39.3 (2004): 499-519. (Academic Article)
Source
manual
Published In
Health Services Research
Volume
39
Issue
3
Publish Date
2004
Start Page
499
End Page
519

Do the near-elderly value mortality risks differently?

Wage hedonic models are estimated with the Health and Retirement Study to measure the risk-wage tradeoffs (value of statistical lives) for older workers. The analysis explicitly allows for multiple employment states, including retirement, using a multinomial selection model. The results suggest that the oldest and most risk-averse workers require significantly higher, not lower, compensation to accept increases in job-related fatality risks.

Authors
Smith, VK; Evans, MF; Kim, H; Jr, DHT
MLA Citation
Smith, VK, Evans, MF, Kim, H, and Jr, DHT. "Do the near-elderly value mortality risks differently?." Review of Economics and Statistics 86.1 (2004): 423-429.
Source
scival
Published In
Review of Economics and Statistics
Volume
86
Issue
1
Publish Date
2004
Start Page
423
End Page
429
DOI
10.1162/003465304774201842

Racial differences in influenza vaccination among older Americans 1996-2000: longitudinal analysis of the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey

BACKGROUND: Influenza is a common and serious public health problem among the elderly. The influenza vaccine is safe and effective. METHODS: The purpose of the study was to determine whether frequencies of receipt vary by race, age group, gender, and time (progress from 1995/1996 to 2000), and whether any racial differences remain in age groups covered by Medicare. Subjects were selected from the Health and Retirement Study (HRS) (12,652 Americans 50-61 years of age (1992-2000)) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (8,124 community-dwelling seniors aged 70+ years (1993-2000)). Using multivariate logistic regression, adjusting for potential confounders, we estimated the relationship between race, age group, gender, time and the main outcome measure, receipt of influenza vaccination in the last 2 years. RESULTS: There has been a clear increase in the unadjusted rates of receipt of influenza vaccination for all groups from 1995/1996 to 2000. However, the proportions immunized are 10-20% higher among White than among Black elderly, with no obvious narrowing of the racial gap from 1995/1996 to 2000. There is an increase in rates from age 50 to age 65. After age 70, the rate appears to plateau. In multivariate analyses, the racial difference remains after adjusting for a series of socioeconomic, health, and health care related variables. (HRS: OR = 0.63 (0.55-0.72), AHEAD: OR = 0.55 (0.44-0.66)) CONCLUSIONS: There is much work left if the Healthy People 2010 goal of 90% of the elderly immunized against influenza annually is to be achieved. Close coordination between public health programs and clinical prevention efforts in primary care is necessary, but to be truly effective, these services must be culturally appropriate.

Authors
Østbye, T; Taylor, DH; Lee, AMAM; Greenberg, G; van Scoyoc, L
MLA Citation
Østbye, T, Taylor, DH, Lee, AMAM, Greenberg, G, and van Scoyoc, L. "Racial differences in influenza vaccination among older Americans 1996-2000: longitudinal analysis of the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey." BMC public health 3 (December 16, 2003): 41-.
Source
scopus
Published In
BMC Public Health
Volume
3
Publish Date
2003
Start Page
41

Racial differences in influenza vaccination among older Americans 1996-2000: longitudinal analysis of the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey.

BACKGROUND: Influenza is a common and serious public health problem among the elderly. The influenza vaccine is safe and effective. METHODS: The purpose of the study was to determine whether frequencies of receipt vary by race, age group, gender, and time (progress from 1995/1996 to 2000), and whether any racial differences remain in age groups covered by Medicare. Subjects were selected from the Health and Retirement Study (HRS) (12,652 Americans 50-61 years of age (1992-2000)) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (8,124 community-dwelling seniors aged 70+ years (1993-2000)). Using multivariate logistic regression, adjusting for potential confounders, we estimated the relationship between race, age group, gender, time and the main outcome measure, receipt of influenza vaccination in the last 2 years. RESULTS: There has been a clear increase in the unadjusted rates of receipt of influenza vaccination for all groups from 1995/1996 to 2000. However, the proportions immunized are 10-20% higher among White than among Black elderly, with no obvious narrowing of the racial gap from 1995/1996 to 2000. There is an increase in rates from age 50 to age 65. After age 70, the rate appears to plateau. In multivariate analyses, the racial difference remains after adjusting for a series of socioeconomic, health, and health care related variables. (HRS: OR = 0.63 (0.55-0.72), AHEAD: OR = 0.55 (0.44-0.66)) CONCLUSIONS: There is much work left if the Healthy People 2010 goal of 90% of the elderly immunized against influenza annually is to be achieved. Close coordination between public health programs and clinical prevention efforts in primary care is necessary, but to be truly effective, these services must be culturally appropriate.

Authors
Østbye, T; Taylor, DH; Lee, AMM; Greenberg, G; van Scoyoc, L
MLA Citation
Østbye, T, Taylor, DH, Lee, AMM, Greenberg, G, and van Scoyoc, L. "Racial differences in influenza vaccination among older Americans 1996-2000: longitudinal analysis of the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey. (Published online)" BMC Public Health 3 (December 16, 2003): 41-.
PMID
14678561
Source
pubmed
Published In
BMC Public Health
Volume
3
Publish Date
2003
Start Page
41
DOI
10.1186/1471-2458-3-41

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

BACKGROUND: We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS: This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998. RESULTS: Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt. CONCLUSIONS: Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
epmc
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Ann Fam Med 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD).

We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys.This cohort study includes participants from 4 waves (1994-2000) of the Health and Retirement Study (HRS)--5,942 women aged 50 to 61 years, and 4 waves (1993-2000) of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey--4,543 women aged 70 years and older. The self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1996 and 2000 for HRS, with predictors of receipt measured in 1994 and 1998. In AHEAD, the self-reported receipt of screening mammograms and Pap smears in the most recent 2 years were reported in 1995 and 2000, with predictors of receipt measured in 1993 and 1998.Receipt of mammography is stable at 70% to 80% among women aged 50 to 64 years, then declines to around 40% among those aged 85 to 90 years. For Pap tests there is a decline from 75% among women aged 50 to 54 years to 25% in those aged 85 to 90 years. For both mammography and Pap tests, the rates increased in all groups from 1995/1996 to 2000. Higher education, being married, higher income, not smoking, and vigorous exercise were consistently associated with higher rates of receipt.Although the use of mammography and Pap tests for screening declines into old age, use has been increasing recently. The large and increasing number of tests performed might not be justified given the lack of evidence of effect in older age-groups.

Authors
Ostbye, T; Greenberg, GN; Taylor, DH; Lee, AMM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor, DH, and Lee, AMM. "Screening mammography and Pap tests among older American women 1996-2000: results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." Annals of family medicine 1.4 (November 2003): 209-217.
PMID
15055410
Source
pubmed
Published In
Annals of family medicine
Volume
1
Issue
4
Publish Date
2003
Start Page
209
End Page
217
DOI
10.1370/afm.54

Caution in the use of the apolipoprotein E e4 allele as a predictor of healthcare costs.

Healthcare payers of all types are interested in accurately predicting future costs. The e4 allele of the gene coding for apolipoprotein E on chromosome 19 (e4 allele) is a potentially attractive genetic marker. This could be used to set insurance premiums or determine whether an insurance policy is actually underwritten because it is a susceptibility marker for Alzheimer's disease, heart disease and stroke. There is some evidence that the apolipoprotein E e4 allele is associated with healthcare costs. However, caution is warranted given the limited number of studies that associate the e4 allele and cost, and concerns regarding selection bias in studies that show an association between the e4 allele and occurrence of costly diseases. Until more is known, the e4 allele should not be used to approve or deny issuance of insurance or to set premium rates for either acute or long-term care insurance.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Caution in the use of the apolipoprotein E e4 allele as a predictor of healthcare costs." Expert Rev Pharmacoecon Outcomes Res 3.5 (October 2003): 569-573.
PMID
19807391
Source
pubmed
Published In
Expert review of pharmacoeconomics & outcomes research
Volume
3
Issue
5
Publish Date
2003
Start Page
569
End Page
573
DOI
10.1586/14737167.3.5.569

Does assistive technology substitute for personal assistance among the disabled elderly?

OBJECTIVES: This study examined whether use of equipment (technological assistance) to cope with disability was associated with use of fewer hours of help from another person (personal assistance). METHODS: In a cross-sectional study of 2368 community dwellers older than 65 years with 1 or more limitations in basic activities of daily living (ADLs) from the 1994 National Long Term Care Survey, the relation between technological assistance and personal assistance was examined. RESULTS: Among people with ADL limitations, multivariate models showed a strong and consistent relation between technological assistance and personal assistance, whereby use of equipment was associated with fewer hours of help. CONCLUSIONS: Among people with disability, use of assistive technology was associated with use of fewer hours of personal assistance.

Authors
Hoenig, H; Taylor, DH; Sloan, FA
MLA Citation
Hoenig, H, Taylor, DH, and Sloan, FA. "Does assistive technology substitute for personal assistance among the disabled elderly?." Am J Public Health 93.2 (February 2003): 330-337.
PMID
12554595
Source
pubmed
Published In
American journal of public health
Volume
93
Issue
2
Publish Date
2003
Start Page
330
End Page
337

Is the APOE epsilon4 genotype associated with higher hospital costs among elderly patients?

OBJECTIVE: The apolipoprotein epsilon4 (APOE epsilon4) genotype is associated with a number of adverse health outcomes. The authors assessed whether the epsilon4 genotype was associated with higher hospital costs on the basis of data from 1,999 white or black respondents to the Duke Established Population for Epidemiological Studies of the Elderly who consented to be genotyped in 1992-1993. METHODS: They measured hospital costs, using the amount paid by Medicare for hospitalizations from 1992 to 1997. RESULTS: Persons with the epsilon4 genotype did not have higher costs than those who were epsilon4-negative. The highest costs were observed for those who had missing epsilon4 genotype. CONCLUSION: The epsilon4 genotype is not a significant predictor of hospital costs, and so would not be a good risk adjustor for purposes such as setting reimbursement rates for Medicare risk plans.

Authors
Taylor, DH; Fillenbaum, G; Burchett, B; Blazer, DG
MLA Citation
Taylor, DH, Fillenbaum, G, Burchett, B, and Blazer, DG. "Is the APOE epsilon4 genotype associated with higher hospital costs among elderly patients?." Am J Geriatr Psychiatry 11.1 (January 2003): 75-82.
PMID
12527542
Source
pubmed
Published In
American Journal of Geriatric Psychiatry
Volume
11
Issue
1
Publish Date
2003
Start Page
75
End Page
82

The Smoking Puzzle: Information, Risk Perception, and Choice

Authors
Sloan, FA; Smith, VK; D H Taylor, J
MLA Citation
Sloan, FA, Smith, VK, and D H Taylor, J. The Smoking Puzzle: Information, Risk Perception, and Choice. Harvard University Press, 2003.
Source
manual
Publish Date
2003

Screening Mammography and Pap Smear Tests Among Older American Women 1996-2000

Authors
Ostbye, T; Greenberg, GN; D H Taylor, J; Lee, AMM; Krause, KM
MLA Citation
Ostbye, T, Greenberg, GN, D H Taylor, J, Lee, AMM, and Krause, KM. "Screening Mammography and Pap Smear Tests Among Older American Women 1996-2000." Annals of Family Medicine 1 (2003): 209-17. (Academic Article)
Source
manual
Published In
Annals of Family Medicine
Volume
1
Publish Date
2003
Start Page
209
End Page
17

Does Higher Hospital Cost Imply Higher Quality of Care?

Authors
Picone, GA; Sloan, FA; Chou, S-Y; D H Taylor, J
MLA Citation
Picone, GA, Sloan, FA, Chou, S-Y, and D H Taylor, J. "Does Higher Hospital Cost Imply Higher Quality of Care?." Review of Economics and Statistics 85 (2003): 51-62. (Academic Article)
Source
manual
Published In
Review of Economics and Statistics
Volume
85
Publish Date
2003
Start Page
51
End Page
62

Comment on "A Systematic Review and Meta-Analysis of Studies Comparing Mortality Rates of Private For-Profit and Private Non-for-Profit Hospitals

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Comment on "A Systematic Review and Meta-Analysis of Studies Comparing Mortality Rates of Private For-Profit and Private Non-for-Profit Hospitals." The Journal of Evidence-Based Medicine (2003). (Academic Article)
Source
manual
Published In
The Journal of Evidence-Based Medicine
Publish Date
2003

Does High Hospital Cost Imply Higher Quality of Care?

Authors
Picone, GA; Sloan, FA; Taylor, DH
MLA Citation
Picone, GA, Sloan, FA, and Taylor, DH. "Does High Hospital Cost Imply Higher Quality of Care?." Review of Economics & Statistics (2003). (Academic Article)
Source
manual
Published In
Review of Economics & Statistics
Publish Date
2003

Is the APOE-4 Genotype Associated with Higher Hospital Costs?

Authors
Taylor, DH; Fillenbaum, G; Burchett, B; Blazer, DG
MLA Citation
Taylor, DH, Fillenbaum, G, Burchett, B, and Blazer, DG. "Is the APOE-4 Genotype Associated with Higher Hospital Costs?." American Journal of Geriatric Psychiatry 11 (2003): 75-82. (Academic Article)
Source
manual
Published In
American Journal of Geriatric Psychiatry
Volume
11
Publish Date
2003
Start Page
75
End Page
82

The Cost of Dementia

Authors
Taylor, DH
MLA Citation
Taylor, DH. "The Cost of Dementia." Research and Practice in Alzheimers Disease. Ed. B Vella and LJ Fitten. Paris, Serdi, 2003. 222-26.
Source
manual
Volume
7
Publish Date
2003
Start Page
222
End Page
26

Comment on "A Systematic Review and Meta-Analysis of Studies Comparing Mortality Rates of Private For-Profit and Private Non-for-Profit Hospitals

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Comment on "A Systematic Review and Meta-Analysis of Studies Comparing Mortality Rates of Private For-Profit and Private Non-for-Profit Hospitals." Canadian Medical Association Journal (2003). (Academic Article)
Source
manual
Published In
Canadian Medical Association Journal
Publish Date
2003

Is the APOE-4 Genotype Associated with Higher Hospital Costs?

Authors
Taylor, DH; Burchett, B; Blazer, DG
MLA Citation
Taylor, DH, Burchett, B, and Blazer, DG. "Is the APOE-4 Genotype Associated with Higher Hospital Costs?." American Journal of Geriatric Psychiatry (2003). (Academic Article)
Source
manual
Published In
American Journal of Geriatric Psychiatry
Publish Date
2003

Does higher hospital cost imply higher quality of care?

This study investigates whether higher input use per stay in the hospital (treatment intensity) and longer length of stay improve outcomes of care. We allow for endogeneity of intensity and length of stay by estimating a quasi-maximum-likelihood discrete factor model, where the distribution of the unmeasured variable is modeled using a discrete distribution. Data on elderly persons come from several waves of the National Long-Term Care Survey merged with Medicare claims data for 1984-1995 and the National Death Index. We find that higher intensity improves patient survival and some dimensions of functional status among those who survive.

Authors
Picone, GA; Sloan, FA; Chou, S-Y; Jr, DHT
MLA Citation
Picone, GA, Sloan, FA, Chou, S-Y, and Jr, DHT. "Does higher hospital cost imply higher quality of care?." Review of Economics and Statistics 85.1 (2003): 51-62.
Website
http://hdl.handle.net/10161/2122
Source
scival
Published In
Review of Economics and Statistics
Volume
85
Issue
1
Publish Date
2003
Start Page
51
End Page
62
DOI
10.1162/003465303762687703

Screening Mammography and Pap Smear Tests Among Older American Women 1996-2000

Authors
Ostbye, T; Greenberg, GN; Taylor Jr, DH; Lee, AMM; Krause, KM
MLA Citation
Ostbye, T, Greenberg, GN, Taylor Jr, DH, Lee, AMM, and Krause, KM. "Screening Mammography and Pap Smear Tests Among Older American Women 1996-2000." Annals of Family Medicine 1 (2003): 209-217. (Academic Article)
Source
manual
Published In
Annals of Family Medicine
Volume
1
Publish Date
2003
Start Page
209
End Page
217

Caution should be used before using the APOE e4 as a predictor of health care costs.

Authors
Taylor Jr, DH
MLA Citation
Taylor Jr, DH. "Caution should be used before using the APOE e4 as a predictor of health care costs." Expert Review of Pharmacoeconomics and Outcomes Research 3 (2003): 569-573. (Academic Article)
Source
manual
Published In
Expert Review of Pharmacoeconomics and Outcomes Research
Volume
3
Publish Date
2003
Start Page
569
End Page
573

Racial Differences in Influenza Vaccination Among Middle Aged and Old Americans, 1996-2000: Results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)

Authors
#216stbye, T; Taylor Jr, DH; Lee, AMM; Greenberg, G; Van Scoyoc, L
MLA Citation
#216stbye, T, Taylor Jr, DH, Lee, AMM, Greenberg, G, and Van Scoyoc, L. "Racial Differences in Influenza Vaccination Among Middle Aged and Old Americans, 1996-2000: Results from the Health and Retirement Study (HRS) and Asset and Health Dynamics Among the Oldest Old (AHEAD)." BMC Public Health 3.41 (2003). (Academic Article)
Source
manual
Published In
BMC Public Health
Volume
3
Issue
41
Publish Date
2003

Erratum: The relative effect of Alzheimer's disease and related dementias, disability, and comorbidities on cost of care for elderly persons (Journals of Gerontology - Series B Psychological Sciences and Social (September 2001) 56B (S285-S293))

Authors
Jr, DHT; Schenkman, M; Zhou, J; Sloan, FA
MLA Citation
Jr, DHT, Schenkman, M, Zhou, J, and Sloan, FA. "Erratum: The relative effect of Alzheimer's disease and related dementias, disability, and comorbidities on cost of care for elderly persons (Journals of Gerontology - Series B Psychological Sciences and Social (September 2001) 56B (S285-S293))." Journals of Gerontology - Series B Psychological Sciences and Social Sciences 58.3 (2003): S198-.
Source
scival
Published In
Journals of Gerontology - Series B Psychological Sciences and Social Sciences
Volume
58
Issue
3
Publish Date
2003
Start Page
S198

Racial differences in influenza vaccination among older Americans 1996-2000: Longitudinal analysis of the Health and Retirement Study (HRS) and the Asset and Health Dynamics among the Oldest Old (AHEAD) survey

Background: Influenza is a common and serious public health problem among the elderly. The influenza vaccine is safe and effective. Methods: The purpose of the study was to determine whether frequencies of receipt vary by race, age group, gender, and time (progress from 1995/1996 to 2000), and whether any racial differences remain in age groups covered by Medicare. Subjects were selected from the Health and Retirement Study (HRS) (12,652 Americans 50-61 years of age (1992-2000)) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (8,124 community-dwelling seniors aged 70+ years (1993-2000)). Using multivariate logistic regression, adjusting for potential confounders, we estimated the relationship between race, age group, gender, time and the main outcome measure, receipt of influenza vaccination in the last 2 years. Results: There has been a clear increase in the unadjusted rates of receipt of influenza vaccination for all groups from 1995/1996 to 2000. However, the proportions immunized are 10-20% higher among White than among Black elderly, with no obvious narrowing of the racial gap from 1995/1996 to 2000. There is an increase in rates from age 50 to age 65. After age 70, the rate appears to plateau. In multivariate analyses, the racial difference remains after adjusting for a series of socioeconomic, health, and health care related variables. (HRS: OR = 0.63 (0.55-0.72), AHEAD: OR = 0.55 (0.44-0.66)) Conclusions: There is much work left if the Healthy People 2010 goal of 90% of the elderly immunized against influenza annually is to be achieved. Close coordination between public health programs and clinical prevention efforts in primary care is necessary, but to be truly effective, these services must be culturally appropriate.

Authors
Østbye, T; Taylor, DH; Lee, AMM; Greenberg, G; Scoyoc, LV
MLA Citation
Østbye, T, Taylor, DH, Lee, AMM, Greenberg, G, and Scoyoc, LV. "Racial differences in influenza vaccination among older Americans 1996-2000: Longitudinal analysis of the Health and Retirement Study (HRS) and the Asset and Health Dynamics among the Oldest Old (AHEAD) survey." BMC Public Health 3 (2003): 1-10.
Source
scival
Published In
BMC Public Health
Volume
3
Publish Date
2003
Start Page
1
End Page
10
DOI
10.1186/1471-2458-3-1

Health insurance and mammography: would a Medicare buy-in take us to universal screening?

OBJECTIVE: To determine whether health insurance expansions via a Medicare buy-in might plausibly increase mammography screening rates among women aged 50-64. DATA SOURCES: Two waves of the Health and Retirement Study (HRS) (1994, 1996). STUDY DESIGN: A longitudinal study with most explanatory variables measured at the second wave of HRS (1994); receipt of mammography, number of physician visits, and breast self exam (BSE) were measured at the third wave (1996). DATA EXTRACTION: Our sample included women aged 50-62 in 1994 who answered the second and third HRS interview (n = 4,583). PRINCIPAL FINDINGS: From 1994 to 1996, 72.7 percent of women received a mammogram. Being insured increased mammography in both unadjusted and adjusted analyses. A simulation of universal insurance coverage in this age group increased mammography rates only to 75-79 percent from the observed 72.7 percent. When we accounted for potential endogeneity of physician visits and BSE to mammography, physician visits remained a strong predictor of mammography but BSE did not. CONCLUSION: Even in the presence of universal coverage and very optimistic scenarios regarding the effect of insurance on mammography for newly insured women, mammography rates would only increase a small amount and gaps in screening would remain. Thus, a Medicare buy-in could be expected to have a small impact on mammography screening rates.

Authors
Taylor, DH; Van Scoyoc, L; Hawley, ST
MLA Citation
Taylor, DH, Van Scoyoc, L, and Hawley, ST. "Health insurance and mammography: would a Medicare buy-in take us to universal screening?." Health Serv Res 37.6 (December 2002): 1469-1486.
PMID
12546282
Source
pubmed
Published In
Health Services Research
Volume
37
Issue
6
Publish Date
2002
Start Page
1469
End Page
1486

The accuracy of medicare claims data in identifying Alzheimer's disease.

We linked Medicare claims data to information on 417 patients with a clinical diagnosis of Alzheimer's disease in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) to determine what proportion of them were identified as having Alzheimer's disease (AD) in Medicare claims records. Seventy-nine percent of these patients were identified as having AD using 5 years of claims data; 87% were identified as demented when a broader set of ICD-9-CM codes was used. An Anderson-Gill counting process approach was used to model the "hazard" of patients being identified as having AD in Medicare claims data. CERAD patients with mild dementia were less likely to be identified in the claims data as having AD. Once identified in Medicare claims as having AD, patients were more likely to be so identified again. When using only the physician supplier and institutional outpatient files, approximately 75% of CERAD patients were identified as having AD; hospital files used alone identified less than one-third (29%) of the CERAD patients as having AD. The data indicate that at least 3 consecutive years of physician supplier and physician outpatient claim files should be used to identify Medicare beneficiaries with AD using Medicare claims.

Authors
Taylor, DH; Fillenbaum, GG; Ezell, ME
MLA Citation
Taylor, DH, Fillenbaum, GG, and Ezell, ME. "The accuracy of medicare claims data in identifying Alzheimer's disease." J Clin Epidemiol 55.9 (September 2002): 929-937.
PMID
12393082
Source
pubmed
Published In
Journal of Clinical Epidemiology
Volume
55
Issue
9
Publish Date
2002
Start Page
929
End Page
937

Benefits of smoking cessation for longevity. (vol 92, pg 990, 2002)

Authors
Taylor, DH; Hasselblad, V; Henley, SJ; Thun, MJ; Sloan, FA
MLA Citation
Taylor, DH, Hasselblad, V, Henley, SJ, Thun, MJ, and Sloan, FA. "Benefits of smoking cessation for longevity. (vol 92, pg 990, 2002)." AMERICAN JOURNAL OF PUBLIC HEALTH 92.9 (September 2002): 1389-1389.
Source
wos-lite
Published In
American journal of public health
Volume
92
Issue
9
Publish Date
2002
Start Page
1389
End Page
1389

Effect of Alzheimer disease on the cost of treating other diseases.

The authors' objective is to determine the effect of diagnosed Alzheimer disease (AD) on cost to Medicare of treating other diseases. Using the 1994 National Long-Term Care Survey merged with Medicare claims and death data, the authors assessed the relative cost to Medicare of covering beneficiaries over 1994-1995 with diagnosed AD relative to other elderly population. They focused on hospitalizations during 1994-1995 for hip fracture, stroke, coronary heart disease, congestive heart failure, and pneumonia. The authors determined whether differences in Medicare payments by AD status mainly reflected differences in rates of occurrence of hospitalizations for the five primary diagnoses, other primary diagnoses, or death during 1994-1995 or in spending given the adverse events. During 1994-1995, an average of $15,700 was spent by Medicare, per person, for those with diagnosed AD, nearly twice the amount spent on others. The difference in Medicare payments was attributable to more adverse events occurring to AD group. Such persons had higher death rates than other elderly population (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.07-1.62), higher hospitalization rates for hip fracture (OR, 1.96; 95% CI, 1.34-2.87), stroke (OR, 1.71; 95% CI, 1.10-2.68), pneumonia (OR, 1.46; 95% CI, 1.07-1.99), and for other reasons than the five conditions (OR, 1.65; 95% CI, 1.38-1.98), but they also had lower hospitalization rates for the cardiac diseases. There were no differences in Medicare payments according to AD diagnosis, controlling for frequency of deaths, hospitalizations, and other factors. Persons with diagnosed AD cost Medicare more because of more adverse health events rather than in intensity of care, given event occurrence.

Authors
Sloan, FA; Taylor, DH
MLA Citation
Sloan, FA, and Taylor, DH. "Effect of Alzheimer disease on the cost of treating other diseases." Alzheimer Dis Assoc Disord 16.3 (July 2002): 137-143.
PMID
12218643
Source
pubmed
Published In
Alzheimer Disease and Associated Disorders
Volume
16
Issue
3
Publish Date
2002
Start Page
137
End Page
143

Apolipoprotein E epsilon4 and risk of mortality in African American and white older community residents.

PURPOSE: The goal of this study was to determine whether the epsilon4 allele of apolipoprotein E is predictive of mortality in a community-based sample. DESIGN AND METHODS: Of the stratified random household sample of 4,162 participants age 65 years and older enrolled in the Duke site of the Established Populations for Epidemiologic Studies of the Elderly, those included in the present study were the 1,998 who were genotyped for apolipoprotein E (alleles epsilon2, epsilon3, and epsilon4) six years after baseline, and for whom survival status eight years later was known by search of the National Death Index. Information on demographic characteristics, physical and mental health status, functional status, and health services use was determined by structured questionnaires administered in person in the home. RESULTS: The epsilon4 allele did not predict mortality for the group as a whole, or for those who were cognitively impaired. It did predict mortality for those who reported having had a heart attack or stroke. IMPLICATIONS: The apolipoprotein epsilon4 allele-although a risk factor for Alzheimer's disease, heart disease, and stroke-was only found to be a risk factor for mortality for those community residents who had had a heart attack or stroke. Otherwise, for this community-based sample, 71 years of age and older, it did not predict time to death and was not a risk factor for mortality.

Authors
Fillenbaum, GG; Blazer, DG; Burchett, BM; Saunders, AM; Taylor, DH
MLA Citation
Fillenbaum, GG, Blazer, DG, Burchett, BM, Saunders, AM, and Taylor, DH. "Apolipoprotein E epsilon4 and risk of mortality in African American and white older community residents." Gerontologist 42.3 (June 2002): 381-386.
PMID
12040140
Source
pubmed
Published In
The Gerontologist
Volume
42
Issue
3
Publish Date
2002
Start Page
381
End Page
386

Benefits of smoking cessation for longevity.

OBJECTIVES: This study determined the life extension obtained from stopping smoking at various ages. METHODS: We estimated the relation between smoking and mortality among 877,243 respondents to the Cancer Prevention Study II. These estimates were applied to the 1990 US census population to examine the longevity benefits of smoking cessation. RESULTS: Life expectancy among smokers who quit at age 35 exceeded that of continuing smokers by 6.9 to 8.5 years for men and 6.1 to 7.7 years for women. Smokers who quit at younger ages realized greater life extensions. However, even those who quit much later in life gained some benefits: among smokers who quit at age 65 years, men gained 1.4 to 2.0 years of life, and women gained 2.7 to 3.7 years. CONCLUSIONS: Stopping smoking as early as possible is important, but cessation at any age provides meaningful life extensions.

Authors
Taylor, DH; Hasselblad, V; Henley, SJ; Thun, MJ; Sloan, FA
MLA Citation
Taylor, DH, Hasselblad, V, Henley, SJ, Thun, MJ, and Sloan, FA. "Benefits of smoking cessation for longevity." Am J Public Health 92.6 (June 2002): 990-996.
PMID
12036794
Source
pubmed
Published In
American journal of public health
Volume
92
Issue
6
Publish Date
2002
Start Page
990
End Page
996

What price for-profit hospitals?

Authors
Taylor, DH
MLA Citation
Taylor, DH. "What price for-profit hospitals?." CMAJ 166.11 (May 28, 2002): 1418-1419.
PMID
12054409
Source
pubmed
Published In
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
Volume
166
Issue
11
Publish Date
2002
Start Page
1418
End Page
1419

The role of smoking and other modifiable lifestyle risk factors in maintaining and restoring lower body mobility in middle-aged and older Americans: results from the HRS and AHEAD. Health and Retirement Study. Asset and Health Dynamics Among the Oldest Old.

OBJECTIVES: To analyze the effect of smoking, smoking cessation, and other modifiable risk factors on mobility in middle-aged and older Americans. DESIGN: Panel study; secondary data analysis. SETTING: United States (national sample). PARTICIPANTS: The Health and Retirement Study (HRS) includes data on 12,652 Americans aged 50 to 61 in four waves (1992-1998). The Asset and Health Dynamics Among the Oldest Old (AHEAD) survey followed 8,124 community-dwelling people aged 70 years and older in three waves (1993-1998). MEASUREMENTS: The relationships between the primary outcome measure, lower body mobility (ability to walk several blocks and walk up one flight of stairs without difficulty), and smoking, exercise (HRS only), body mass index (BMI), and alcohol use were estimated in bivariate and multivariate analyses. RESULTS: Not smoking was strongly positively related to mobility, and the relative effects were similar in both panels. Among those with impaired mobility at baseline, not smoking was also strongly related to recovery. In the middle aged, there were consistent dose-response relationships between amount smoked and impaired mobility. Fifteen years after quitting, the risk of impaired mobility returned to that of never smokers. There was also a strong dose-response relationship between level of exercise and mobility. Inverted U-shaped relationships with mobility were observed for BMI and alcohol consumption. CONCLUSIONS: The relationships between not smoking and lower body mobility in middle-aged and older Americans are strong and consistent. Interventions aimed at reducing smoking have the potential to preserve mobility and thereby prolong health and independence in later life.

Authors
Ostbye, T; Taylor, DH; Krause, KM; Van Scoyoc, L
MLA Citation
Ostbye, T, Taylor, DH, Krause, KM, and Van Scoyoc, L. "The role of smoking and other modifiable lifestyle risk factors in maintaining and restoring lower body mobility in middle-aged and older Americans: results from the HRS and AHEAD. Health and Retirement Study. Asset and Health Dynamics Among the Oldest Old." J Am Geriatr Soc 50.4 (April 2002): 691-699.
PMID
11982670
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
50
Issue
4
Publish Date
2002
Start Page
691
End Page
699

A longitudinal study of the effects of tobacco smoking and other modifiable risk factors on ill health in middle-aged and old Americans: results from the Health and Retirement Study and Asset and Health Dynamics among the Oldest Old survey.

BACKGROUND: While the effects of smoking and other modifiable risk factors on mortality and specific diseases are well established, their effects on ill health more generally are less known. Using two national, longitudinal surveys, the objective of this study was to analyze the effect of smoking and other modifiable risk factors on ill health, defined in a multidimensional fashion (i.e., disability, impaired mobility, health care utilization, and self-reported health). METHODS: The analyses were based on the Health and Retirement Study (HRS) (12,652 persons 50-60 years old surveyed in 1992, 1994, 1996, and 1998) and the Asset and Health Dynamics among the Oldest Old survey (8,124 persons 60-70 years old surveyed in 1993, 1996, and 1998). RESULTS: Smoking was strongly related to mortality and to ill health, with similar relative effects in the middle-aged and the elderly. There were consistent adverse dose-response relationships between smoking and ill health in the HRS. Persons who had quit smoking at least 15 years prior to the survey were no more likely than never smokers to experience ill health. A dose-response relationship was found between exercise and ill health. For body mass index and alcohol, there were U-shaped relationships with ill health. CONCLUSIONS: Public health efforts designed to encourage smoking cessation should emphasize improvements in ill health in addition to decreased mortality.

Authors
Østbye, T; Taylor, DH; Jung, S-H
MLA Citation
Østbye, T, Taylor, DH, and Jung, S-H. "A longitudinal study of the effects of tobacco smoking and other modifiable risk factors on ill health in middle-aged and old Americans: results from the Health and Retirement Study and Asset and Health Dynamics among the Oldest Old survey." Prev Med 34.3 (March 2002): 334-345.
PMID
11902850
Source
pubmed
Published In
Preventive Medicine
Volume
34
Issue
3
Publish Date
2002
Start Page
334
End Page
345
DOI
10.1006/pmed.2001.0991

Health insurance and mammography: Would a medicare buy-in take us to universal screening?

Objective. To determine whether health insurance expansions via a Medicare buy-in might plausibly increase mammography screening rates among women aged 50-64. Data Sources. Two waves of the Health and Retirement Study (HRS) (1994, 1996). Study Design. A longitudinal study with most explanatory variables measured at the second wave of HRS (1994); receipt of mammography, number of physician visits, and breast self exam (BSE) were measured at the third wave (1996). Data Extraction. Our sample included women aged 50-62 in 1994 who answered the second and third HRS interview (n = 4,583). Principal Findings. From 1994 to 1996, 72.7 percent of women received a mammogram. Being insured increased mammography in both unadjusted and adjusted analyses. A simulation of universal insurance coverage in this age group increased mammography rates only to 75-79 percent from the observed 72.7 percent. When we accounted for potential endogeneity of physician visits and BSE to mammography, physician visits remained a strong predictor of mammography but BSE did not. Conclusion. Even in the presence of universal coverage and very optimistic scenarios regarding the effect of insurance on mammography for newly insured women, mammography rates would only increase a small amount and gaps in screening would remain. Thus, a Medicare buy-in could be expected to have a small impact on mammography screening rates.

Authors
Taylor, DH; Van Scoyoc, L; Hawley, ST
MLA Citation
Taylor, DH, Van Scoyoc, L, and Hawley, ST. "Health insurance and mammography: Would a medicare buy-in take us to universal screening?." Health Services Research 37.6 (January 1, 2002): 1469-1486.
Source
scopus
Published In
Health Services Research
Volume
37
Issue
6
Publish Date
2002
Start Page
1469
End Page
1486

Information, addiction, and 'bad choices': Lessons from a century of cigarettes

This study describes government interventions during the 1900s and their effects on cigarette consumption within a rational addiction framework. With annual data for the 20th century, impacts of specific antismoking information events disappear. U.S. per capita cigarette demand changed before any information about health effects of smoking was widely distributed. © 2002 Elsevier Science B.V. All rights reserved.

Authors
Sloan, FA; Smith, VK; Jr, DHT
MLA Citation
Sloan, FA, Smith, VK, and Jr, DHT. "Information, addiction, and 'bad choices': Lessons from a century of cigarettes." Economics Letters 77.2 (2002): 147-155.
Source
scival
Published In
Economics Letters
Volume
77
Issue
2
Publish Date
2002
Start Page
147
End Page
155
DOI
10.1016/S0165-1765(02)00134-9

A Longitudinal Study of the Effects of Tobacco Smoking and Other Modifiable Risk Factors on Ill Health in Middle Aged and Old Americans

Authors
Truls, ; 216stbye, ; Taylor, DH; Hyauk, S
MLA Citation
Truls, , 216stbye, , Taylor, DH, and Hyauk, S. "A Longitudinal Study of the Effects of Tobacco Smoking and Other Modifiable Risk Factors on Ill Health in Middle Aged and Old Americans." Preventive Medicine 34 (2002): 334-345. (Academic Article)
Source
manual
Published In
Preventive Medicine
Volume
34
Publish Date
2002
Start Page
334
End Page
345

The role of smoking and other modifiable lifestyle risk factors in maintaining and restoring lower body mobility in middle-aged and older Americans: Results from the HRS and AHEAD

OBJECTIVES: To analyze the effect of smoking, smoking cessation, and other modifiable risk factors on mobility in middle-aged and older Americans. DESIGN: Panel study; secondary data analysis. SETTING: United States (national sample). PARTICIPANTS: The Health and Retirement Study (HRS) includes data on 12,652 Americans aged 50 to 61 in four waves (1992-1998). The Asset and Health Dynamics Among the Oldest Old (AHEAD) survey followed 8,124 community-dwelling people aged 70 years and older in three waves (1993-1998). MEASUREMENTS: The relationships between the primary outcome measure, lower body mobility (ability to walk several blocks and walk up one flight of stairs without difficulty), and smoking, exercise (HRS only), body mass index (BMI), and alcohol use were estimated in bivariate and multivariate analyses. RESULTS: Not smoking was strongly positively related to mobility, and the relative effects were similar in both panels. Among those with impaired mobility at baseline, not smoking was also strongly related to recovery. In the middle aged, there were consistent dose-response relationships between amount smoked and impaired mobility. Fifteen years after quitting, the risk of impaired mobility returned to that of never smokers. There was also a strong dose-response relationship between level of exercise and mobility. Inverted U-shaped relationships with mobility were observed for BMI and alcohol consumption. CONCLUSIONS: The relationships between not smoking and lower body mobility in middle-aged and older Americans are strong and consistent. Interventions aimed at reducing smoking have the potential to preserve mobility and thereby prolong health and independence in later life.

Authors
ØStbye, T; Jr, DHT; Krause, KM; Scoyoc, LV
MLA Citation
ØStbye, T, Jr, DHT, Krause, KM, and Scoyoc, LV. "The role of smoking and other modifiable lifestyle risk factors in maintaining and restoring lower body mobility in middle-aged and older Americans: Results from the HRS and AHEAD." Journal of the American Geriatrics Society 50.4 (2002): 691-699.
Source
scival
Published In
Journal of American Geriatrics Society
Volume
50
Issue
4
Publish Date
2002
Start Page
691
End Page
699
DOI
10.1046/j.1532-5415.2002.50164.x

Erratum: Benefits of smoking cessation for longevity (American Journal of Public Health (2002) 92 (990-996))

Authors
Jr, DHT; Hasselblad, V; Henley, SJ; Thun, MJ; Sloan, FA
MLA Citation
Jr, DHT, Hasselblad, V, Henley, SJ, Thun, MJ, and Sloan, FA. "Erratum: Benefits of smoking cessation for longevity (American Journal of Public Health (2002) 92 (990-996))." American Journal of Public Health 92.9 (2002): 1389--.
Source
scival
Published In
American Journal of Public Health
Volume
92
Issue
9
Publish Date
2002
Start Page
1389-

Private for-profit ownership of hospitals may be associated with a slightly higher mortality rate than not-for-profit hospitals

Authors
Devereaux, P; Choi, P; Lacchetti, C; Weaver, B; Schunemann, H; Haines, T; Lavis, J; Grant, B; Haslam, D; Bhandari, M; Sullivan, T; Cook, D; Walter, S; Meade, M; Khan, H; Bhatnagar, N; Guyatt, G; Jr, DHT; Potter, SJ
MLA Citation
Devereaux, P, Choi, P, Lacchetti, C, Weaver, B, Schunemann, H, Haines, T, Lavis, J, Grant, B, Haslam, D, Bhandari, M, Sullivan, T, Cook, D, Walter, S, Meade, M, Khan, H, Bhatnagar, N, Guyatt, G, Jr, DHT, and Potter, SJ. "Private for-profit ownership of hospitals may be associated with a slightly higher mortality rate than not-for-profit hospitals." Evidence-Based Healthcare 6.4 (2002): 139-140.
Source
scival
Published In
Evidence-Based Healthcare
Volume
6
Issue
4
Publish Date
2002
Start Page
139
End Page
140
DOI
10.1054/ebhc.2002.0559

The effect of middle- and old-age body mass index on short-term mortality in older people.

OBJECTIVES: To determine the effect of body mass index (BMI) at old age and at age 50 on short-term survival among persons age 65 and older. DESIGN: Cross-sectional, using the 4,791 respondents to the community interview of the 1994 National Long Term Care Survey (NLTCS). SETTING: United States of America. PARTICIPANTS: Persons age 65 and older who lived in community settings as of the 1994 NLTCS interview. MEASUREMENTS: Short-term mortality was measured from the date of the 1994 NLTCS through year-end 1995. BMI (kg/m2) (at three points: 1994 NLTCS, 1 year before, age 50) and all other variables, including three other modifiable risk factors known to be related to mortality--cigarette smoking, alcohol consumption, and exercise--were based on self-report. RESULTS: Both the unadjusted and adjusted nadirs of mortality in relation to BMI at old age were found in older persons with a BMI between 30 and 34.9; this was true for males and females in all age groups. The highest mortality rates were found for older persons with very low BMI (<18.5). In contrast, BMI at age 50 was positively related to mortality, with those in the lowest BMI category (<18.5) at age 50 having the lowest mortality. Persons who were obese at age 50 and who were no longer obese at the 1994 NLTCS had lower mortality than persons with stable weight. CONCLUSIONS: Weight reduction by middle-aged persons who are obese should be reinforced as a public health priority, because there is evidence that long-term weight loss results in better short-term survival. Further study of healthy older survivors to determine why they are not harmed by heavier weight in old age may provide useful insights into successful aging.

Authors
Taylor, DH; Ostbye, T
MLA Citation
Taylor, DH, and Ostbye, T. "The effect of middle- and old-age body mass index on short-term mortality in older people." J Am Geriatr Soc 49.10 (October 2001): 1319-1326.
PMID
11890490
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
49
Issue
10
Publish Date
2001
Start Page
1319
End Page
1326

The relative effect of Alzheimer's disease and related dementias, disability, and comorbidities on cost of care for elderly persons.

OBJECTIVES: Our primary objectives were (a) to determine the relative impact of Alzheimer's disease and related dementias (ADRD), disability, and common comorbid health conditions on the cost of caring for community-dwelling elderly person and (b) to determine whether ADRD serves as an effect modifier for the effect of disability and common comorbidities on costs. METHODS: Participants were drawn from community respondents to the 1994 National Long Term Care Survey. The authors compared total cost of caring for persons without ADRD with that of those who had moderate and severe ADRD. Using regression analysis, the author identified the adjusted effect of ADRD, limitations in activities of daily living (ADLs), and common comorbidities on total costs. RESULTS: Persons with severe ADRD had higher median total costs ($10,234) than did persons with moderate ADRD ($4,318) and those without ADRD ($2,268, p <.001). However, disability measured by ADL limitations was a more important predictor of total cost than was ADRD status in both stratified and multivariate analyses. Comorbidities such as heart attack, stroke, and chronic obstructive pulmonary disease also increased costs. Severe ADRD was an effect modifier for ADL limitations, increasing the positive impact of disability on total costs among persons with severe ADRD, but not for comorbidities. DISCUSSION: Disability, severe ADRD, and comorbidity all had independent effects that increased total costs. Thus, any risk adjustment procedure should account for disability and comorbidity and not just ADRD status.

Authors
Taylor, DH; Schenkman, M; Zhou, J; Sloan, FA
MLA Citation
Taylor, DH, Schenkman, M, Zhou, J, and Sloan, FA. "The relative effect of Alzheimer's disease and related dementias, disability, and comorbidities on cost of care for elderly persons." J Gerontol B Psychol Sci Soc Sci 56.5 (September 2001): S285-S293.
PMID
11522810
Source
pubmed
Published In
Journals of Gerontology: Series B
Volume
56
Issue
5
Publish Date
2001
Start Page
S285
End Page
S293

What we know is not enough.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "What we know is not enough." Contemp Longterm Care 24.7 (July 2001): 30-31.
PMID
11452810
Source
pubmed
Published In
Contemporary longterm care
Volume
24
Issue
7
Publish Date
2001
Start Page
30
End Page
31

Effects of tobacco smoking and other modifiable risk factors on ill health: Results from HRS and ahead.

Authors
Ostbye, T; Taylor, DH; Jung, SH
MLA Citation
Ostbye, T, Taylor, DH, and Jung, SH. "Effects of tobacco smoking and other modifiable risk factors on ill health: Results from HRS and ahead." AMERICAN JOURNAL OF EPIDEMIOLOGY 153.11 (June 1, 2001): S59-S59.
Source
wos-lite
Published In
American Journal of Epidemiology
Volume
153
Issue
11
Publish Date
2001
Start Page
S59
End Page
S59

Hospital ownership and cost and quality of care: is there a dime's worth of difference?

Nonprofit organizations may predominate when output quality is difficult to monitor. Hospital care has this characteristic. This study compared program cost and quality of care for Medicare patients hospitalized following onset of four common conditions by hospital ownership. Payments on behalf of Medicare patients admitted to for-profit hospitals during the first 6 months following a health shock were higher than for those admitted to other hospitals. With quality measured in terms of survival, changes in functional and cognitive status, and living arrangements, we found no differences in outcomes by hospital ownership.

Authors
Sloan, FA; Picone, GA; Taylor, DH; Chou, SY
MLA Citation
Sloan, FA, Picone, GA, Taylor, DH, and Chou, SY. "Hospital ownership and cost and quality of care: is there a dime's worth of difference?." J Health Econ 20.1 (January 2001): 1-21.
PMID
11148866
Source
pubmed
Published In
Journal of Health Economics
Volume
20
Issue
1
Publish Date
2001
Start Page
1
End Page
21

Long Term Care Insurance that Works

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Long Term Care Insurance that Works." (2001).
Source
manual
Publish Date
2001

the Cost of Alzheimer’s Disease

Authors
Taylor, DH
MLA Citation
Taylor, DH. "the Cost of Alzheimer’s Disease." Research and Practice in Alzheimers Disease. Ed. B Vella and LJ Fitten. Paris: Serdi, 2001. 222-226.
Source
manual
Volume
56
Publish Date
2001
Start Page
222
End Page
226

Are Smokers Too Optimistic?

Authors
Sloan, FA; Smith, VK; Donald H Taylor, J
MLA Citation
Sloan, FA, Smith, VK, and Donald H Taylor, J. "Are Smokers Too Optimistic?." The Economic Analysis of Substance Use and Abuse: The Experience of Developed Countries and Lessons for Developing Countries. Ed. M Grossman and C-R Hsieh. Cheltenham, UK: Edward Elgar Publishing Limited, 2001.
Source
manual
Publish Date
2001

Assistive Technology is Associated with Reduced Use of Personal Assistance among Disabled Older Persons

Authors
Sloan, FA; Hoenig, H; Taylor, D
MLA Citation
Sloan, FA, Hoenig, H, and Taylor, D. "Assistive Technology is Associated with Reduced Use of Personal Assistance among Disabled Older Persons." Journal of the American Geriatrics Society 49.4 (2001): S13-A14.
Source
manual
Published In
Journal of the American Geriatrics Society
Volume
49
Issue
4
Publish Date
2001
Start Page
S13
End Page
A14

Alzheimer's Disease Cost: What We Know is Not Enough

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Alzheimer's Disease Cost: What We Know is Not Enough." Contemporary Long Term Care 24.7 (2001): 30-33. (Academic Article)
Source
manual
Published In
Contemporary Long Term Care
Volume
24
Issue
7
Publish Date
2001
Start Page
30
End Page
33

The Relative Effect of Body Mass Index at Age 50 and Old Age on Mortality Among the Elderly

Authors
Taylor, DH; Jr, ; Truls, ; 216stbye,
MLA Citation
Taylor, DH, Jr, , Truls, , and 216stbye, . "The Relative Effect of Body Mass Index at Age 50 and Old Age on Mortality Among the Elderly." The Journal of the American Geriatrics Society 49 (2001): 1319-1326. (Academic Article)
Source
manual
Published In
The Journal of the American Geriatrics Society
Volume
49
Publish Date
2001
Start Page
1319
End Page
1326

The Effect of Disability and Comorbidity on the Cost of Alzheimer's Disease and Related Dementias

Authors
Taylor, DH; Schenkman, M; Zhou, J; Sloan, FA
MLA Citation
Taylor, DH, Schenkman, M, Zhou, J, and Sloan, FA. "The Effect of Disability and Comorbidity on the Cost of Alzheimer's Disease and Related Dementias." Journal of Gerontology: Social Sciences 56.5 (2001): 285-293. (Academic Article)
Source
manual
Published In
Journal of Gerontology: Social Sciences
Volume
56
Issue
5
Publish Date
2001
Start Page
285
End Page
293

Longevity expectations and death: Can people predict their own demise?

Authors
Smith, VK; Jr, DHT; Sloan, FA
MLA Citation
Smith, VK, Jr, DHT, and Sloan, FA. "Longevity expectations and death: Can people predict their own demise?." American Economic Review 91.4 (2001): 1126-1134.
Website
http://hdl.handle.net/10161/1855
Source
scival
Published In
American Economic Review
Volume
91
Issue
4
Publish Date
2001
Start Page
1126
End Page
1134

Do smokers respond to health shocks?

This paper reports the first effort to use data to evaluate how new information, acquired through exogenous health shocks, affects people's longevity expectations. We find that smokers react differently to health shocks than do those who quit smoking or never smoked. These differences, together with insights from qualitative research conducted along with the statistical analysis, suggest specific changes in the health warnings used to reduce smoking. Our specific focus is on how current smokers responded to health information in comparison to former smokers and nonsmokers. The three groups use significantly different updating rules to revise their assessments about longevity. The most significant finding of our study documents that smokers differ from persons who do not smoke in how information influences their personal longevity expectations. When smokers experience smoking-related health shocks, they interpret this information as reducing their chances of living to age 75 or more. Our estimated models imply smokers update their longevity expec-tations more dramatically than either former smokers or those who never smoked. Smokers are thus assigning a larger risk equivalent to these shocks. They do not react comparably to general health shocks, implying that specific information about smoking-related health events is most likely to cause them to update beliefs. It remains to be evaluated whether messages can be designed that focus on the link between smoking and health outcomes in ways that will have comparable effects on smokers' risk perceptions.

Authors
Smith, VK; Jr, DHT; Sloan, FA; Johnson, FR; Desvousges, WH
MLA Citation
Smith, VK, Jr, DHT, Sloan, FA, Johnson, FR, and Desvousges, WH. "Do smokers respond to health shocks?." Review of Economics and Statistics 83.4 (2001): 675-687.
Website
http://hdl.handle.net/10161/2127
Source
scival
Published In
Review of Economics and Statistics
Volume
83
Issue
4
Publish Date
2001
Start Page
675
End Page
687
DOI
10.1162/003465301753237759

Hospital Ownership and Cost and Quality of Care: Is there a Dime's Worth of Difference?

Authors
Sloan, FA; Picone, GA; Taylor Jr, DH; Chou, S-Y
MLA Citation
Sloan, FA, Picone, GA, Taylor Jr, DH, and Chou, S-Y. "Hospital Ownership and Cost and Quality of Care: Is there a Dime's Worth of Difference?." Journal of Health Economics 29.1 (2001): 1-21. (Academic Article)
Source
manual
Published In
Journal of Health Economics
Volume
29
Issue
1
Publish Date
2001
Start Page
1
End Page
21

How much do persons with Alzheimer's disease cost Medicare?

BACKGROUND: Medicare claims are increasingly being used to identify persons with chronic diseases such as Alzheimer's disease (AD) for the purpose of determining the cost to Medicare of caring for such persons. Past work has been limited by the use of only 1 or 2 years of claims data to identify cases, leading to worries that this might lead to an undercount of prevalent cases and bias cost findings. OBJECTIVES: To analyze the average total cost to the Medicare program in 1994 of persons with a claims-based diagnosis of AD, using a 12-year period of claims history to identify prevalent cases, and to investigate the effect on cost of time since diagnosis. DESIGN: A cross-sectional design with a 12-year retrospective period to identify persons with AD. SETTING: Medical care practices, hospitals, and other providers of services to Medicare beneficiaries in the US in 1994. SUBJECTS: Respondents to the screener (n = 10,858) and community (5429) and institutional (n = 1341) questionnaire of the 1994 National Long Term Care Survey, with and without a claims-based diagnosis of AD. MEASUREMENTS: Average total cost to Medicare in 1994, measured as the actual amount Medicare paid for inpatient, outpatient, home health, skilled nursing facility, hospice, and Part B services, including payments to physicians, and other items such as durable medical equipment. We also measured disability in a variety of ways, including cognition, activity limitations, and residence in a nursing home. RESULTS: The average total cost to Medicare of persons with a claims-based diagnosis of AD was $6021 versus $2310 (P < .001) for persons without a diagnosis. When adjusting for patient characteristics, the ratio of cost between persons with AD and those without was reduced to about 1.6 to 1. Time since diagnosis was an important predictor of average total cost in 1994, with each additional year since diagnosis resulting in a $248 (P = .04) decrease in total cost (about 10% of the total sample mean cost of $2426). There was mixed evidence that persons with a diagnosis of AD incurred less cost than otherwise similarly disabled Medicare beneficiaries. CONCLUSIONS: Time since diagnosis with AD is an important predictor of cost and one that should be explicitly included in any rate-setting formula. Expanding the period used to identify cases resulted in an increase in the unadjusted ratio of cost of a Medicare beneficiary with AD relative to one without primarily because our control group costs are lower compared with those of past work.

Authors
Taylor, DH; Sloan, FA
MLA Citation
Taylor, DH, and Sloan, FA. "How much do persons with Alzheimer's disease cost Medicare?." J Am Geriatr Soc 48.6 (June 2000): 639-646.
PMID
10855599
Source
pubmed
Published In
Journal of American Geriatrics Society
Volume
48
Issue
6
Publish Date
2000
Start Page
639
End Page
646

Hospital Conversions: Is the Purchase Price Too Low?

Authors
Sloan, FA; Donald H Taylor, J; Conover, C
MLA Citation
Sloan, FA, Donald H Taylor, J, and Conover, C. "Hospital Conversions: Is the Purchase Price Too Low?." The Changing Hospital Industry: Comparing Not-for-Profit and For-Profit Institutions. Ed. DM Cutler. Chicago: University of Chicago Press, 2000. 13-44.
Source
manual
Publish Date
2000
Start Page
13
End Page
44

State scholarship, loan forgiveness, and related programs: The unheralded safety net

Context: In the mid-1980s, states expanded their initiatives of scholarships, loan repayment programs, and similar incentives to recruit primary care practitioners into underserved areas. With no national coordination or mandate to publicize these efforts, little is known about these state programs and their recent growth. Objectives: To identify and describe state programs that provide financial support to physicians and midlevel practitioners in exchange for a period of service in underserved areas, and to begin to assess the magnitude of the contributions of these programs to the US health care safety net. Design: Cross-sectional, descriptive study of data collected by telephone, mail questionnaires, and through other available documents, (eg, program brochures, Web sites). Setting and Participants: All state programs operating in 1996 that provided financial support in exchange for service in defined underserved areas to student, resident, and practicing physicians; nurse practitioners; physician assistants; and nurse midwives. We excluded local community initiatives and programs that received federal support, including that from the National Health Service Corps. Main Outcome Measures: Number and types of state support-for-service programs in 1996; trends in program types and numbers since 1990; distribution of programs across states; numbers of participating physicians and other practitioners in 1996; numbers in state programs relative to federal programs; and basic features of state programs. Results: In 1996, there were 82 eligible programs operating in 41 states, including 29 loan repayment programs, 29 scholarship programs, 11 loan programs, 8 direct financial incentive programs, and 5 resident support programs. Programs more than doubled in number between 1990 (n=39) and 1996 (n=82). In 1996, an estimated 1306 physicians and 370 midlevel practitioners were serving obligations to these state programs, a number comparable with those in federal programs. Common features of state programs were a mission to influence the distribution of the health care workforce within their states' borders, an emphasis on primary care, and reliance on annual state appropriations and other public funding mechanisms. Conclusions: In 1996, states fielded an obligated primary care workforce comparable in size to the better-known federal programs. These state programs constitute a major portion of the US health care safety net, and their activities should be monitored, coordinated, and evaluated. State programs should not be omitted from listings of safety-net initiatives or overlooked in future plans to further improve health care access.

Authors
Pathman, DE; Jr, DHT; Konrad, TR; King, TS; Harris, T; Henderson, TM; Bernstein, JD; Tucker, T; Crook, KD; Spaulding, C; Koch, GG
MLA Citation
Pathman, DE, Jr, DHT, Konrad, TR, King, TS, Harris, T, Henderson, TM, Bernstein, JD, Tucker, T, Crook, KD, Spaulding, C, and Koch, GG. "State scholarship, loan forgiveness, and related programs: The unheralded safety net." Journal of the American Medical Association 284.16 (2000): 2084-2092.
PMID
11042757
Source
scival
Published In
JAMA : the journal of the American Medical Association
Volume
284
Issue
16
Publish Date
2000
Start Page
2084
End Page
2092

Medical training debt and service commitments: The rural consequences

This study assesses how student loan debt and scholarships, loan repayment and related programs with service requirements influence the incomes young physicians seek and attain, influence whether they choose to work in rural practice settings and affect the number of Medicaid-covered and uninsured patients they see. Data are from a 1999 mail survey of a national probability sample of 468 practicing family physicians, general internists and pediatricians who graduated from U.S. medical schools in 1988 and 1992. A majority of these generalist physicians recalled 'moderate' or 'great' concern for their financial situations before, during and after their training. Eighty percent financed all or part of their training with loans, and one-quarter received support from federal, state or community-sponsored scholarship, loan repayment and similar programs with service obligations. In their first job after residency, family physicians and pediatricians with greater debt reported caring for more patients insured under Medicaid and uninsured than did those with less debt. For no specialty was debt associated with physicians' income or likelihood of working in a rural area. Physicians serving commitments in exchange for training cost support, compared to those without obligations, were more likely to work in rural areas (33 vs. 7 percent, respectively, p<0.001) and provided care to more Medicaid-covered and uninsured patients (53 vs. 29 percent, p<0.001), but did not differ in their incomes ($99,600 vs. $93,800, p=0.11). Thus, among physicians who train as generalists, the high costs of medical education appear to promote, not harm, national physician work force goals by prompting participation in service-requiring financial support programs and perhaps through increasing student borrowing. These positive outcomes for generalists should be weighed against other known and suspected negative consequences of the high costs of training, such as discouraging some poor students from medical careers altogether and perhaps influencing some medical students with high debt not to pursue primary care careers.

Authors
Pathman, DE; Konrad, TR; King, TS; Spaulding, C; Jr, TDH
MLA Citation
Pathman, DE, Konrad, TR, King, TS, Spaulding, C, and Jr, TDH. "Medical training debt and service commitments: The rural consequences." Journal of Rural Health 16.3 (2000): 264-272.
PMID
11131772
Source
scival
Published In
Journal of Rural Health
Volume
16
Issue
3
Publish Date
2000
Start Page
264
End Page
272

Hospital conversions - Is the purchase price too low?

Authors
Sloan, FA; Taylor, DH; Conover, CJ
MLA Citation
Sloan, FA, Taylor, DH, and Conover, CJ. "Hospital conversions - Is the purchase price too low?." 2000.
Source
wos-lite
Published In
CHANGING HOSPITAL INDUSTRY
Publish Date
2000
Start Page
13
End Page
44

Private and public choices in end-of-life care.

Authors
Sloan, FA; Taylor, DH
MLA Citation
Sloan, FA, and Taylor, DH. "Private and public choices in end-of-life care." JAMA 282.21 (December 1, 1999): 2078-.
PMID
10591394
Source
pubmed
Published In
JAMA : the journal of the American Medical Association
Volume
282
Issue
21
Publish Date
1999
Start Page
2078

Formation of trusts and spend down to Medicaid.

OBJECTIVE: To identify the proportion of community-dwelling elderly persons (70+) who could affect their eligibility for Medicaid financing of a nursing home stay through the use of a trust and to quantify the prevalence and predictors of trusts. METHODS: State-specific Medicaid eligibility regulations were used to determine eligibility and to identify those who could affect the same through the use of trusts. Multivariate logistic regression was used to identify correlates of having a trust. Wave 1 of the Assets and Health Dynamics of the Oldest Old (AHEAD) data base was used. RESULTS: Four in 10 elderly community dwellers could potentially qualify for Medicaid by using a trust; however, less than 10% had a trust. On average, wealthier persons had trusts. Avoidance of probate and controlling assets after death appear to be stronger motivations for trust creation among the elderly than achieving Medicaid spend down. DISCUSSION: The use of trusts was not common, and motives other than spend down were more important for those with trusts. Our results suggest little need for policy efforts to limit the use of trusts to achieve spend down.

Authors
Taylor, DH; Sloan, FA; Norton, EC
MLA Citation
Taylor, DH, Sloan, FA, and Norton, EC. "Formation of trusts and spend down to Medicaid." J Gerontol B Psychol Sci Soc Sci 54.4 (July 1999): S194-S201.
PMID
12382597
Source
pubmed
Published In
Journals of Gerontology: Series B
Volume
54
Issue
4
Publish Date
1999
Start Page
S194
End Page
S201

Costs and outcomes of hip fracture and stroke, 1984 to 1994.

OBJECTIVES: This study quantified changes in Medicare payments and outcomes for hip fracture and stroke from 1984 to 1994. METHODS: We studied National Long Term Care Survey respondents who were hospitalized for hip fracture (n = 887) or stroke (n = 878) occurring between 1984 and 1994. Changes in Medicare payment and survival were primary outcomes. We also assessed changes in functional and cognitive status. RESULTS: Medicare payments within 6 months increased following hip fracture (103%) or stroke (51%). Survival improved for stroke (P < .001) and to a lesser extent for hip fracture (P = .16). Condition-specific improvements were found in functional and cognitive status. CONCLUSIONS: During the period 1984 to 1994, Medicare payments for hip fracture and stroke rose and there were some improvements in survival and other outcomes.

Authors
Sloan, FA; Taylor, DH; Picone, G
MLA Citation
Sloan, FA, Taylor, DH, and Picone, G. "Costs and outcomes of hip fracture and stroke, 1984 to 1994." Am J Public Health 89.6 (June 1999): 935-937.
PMID
10358692
Source
pubmed
Published In
American journal of public health
Volume
89
Issue
6
Publish Date
1999
Start Page
935
End Page
937

Retention of young general practitioners entering the NHS from 1991-1992.

BACKGROUND: The supply of general practitioners (GPs) in the National Health Service (NHS) is dynamic and there are fears that there will be an inadequate number of doctors to meet the needs of the NHS. There are particular concerns about changes in the career trajectory of young GPs and what they mean for overall supply. AIM: To identify predictors of retention among young, new entrant GPs entering the NHS between 1 October 1991 and 1 October 1992. METHOD: Two-year retention rates of young (35 years of age or less) new entrant GPs have been modelled using a multilevel logit model. Retention is defined as young, new entrant GPs remaining in their initial health authority for two years or more. RESULTS: Two hundred and fifty-two (13.0%) members of the study group left general practice within two years of entry (i.e. were not retained). Sex (females had lower retention [95% CI = 0.43-0.75]), practice size (young GPs in larger practices had higher retention [95% CI = 1.10-1.29]), and belonging to a practice in one of 16 Greater London Health Authorities (which had lower retention [95% CI = 0.39-0.82]) were identified as major predictors of retention. Deprivation, measured at the individual GP patient list level, had a very slight association with retention (P = 0.097; 95% CI = 1.00-1.02). Deprivation measured at the health authority level (95% CI = 0.99-1.01) was not found to be a statistically significant predictor of retention (P = 0.83). CONCLUSION: None of the statistically significant predictors of retention suggest any policy panacea to end this phenomenon. The challenge for policy is to learn to deal with the dynamic nature of the GP workforce with a non-crisis mentality.

Authors
Taylor, DH; Quayle, JA; Roberts, C
MLA Citation
Taylor, DH, Quayle, JA, and Roberts, C. "Retention of young general practitioners entering the NHS from 1991-1992." Br J Gen Pract 49.441 (April 1999): 277-280.
PMID
10736904
Source
pubmed
Published In
British Journal of General Practice
Volume
49
Issue
441
Publish Date
1999
Start Page
277
End Page
280

Retrospective analysis of census data on general practitioners who qualified in South Asia: who will replace them as they retire?

OBJECTIVES: To determine the number and geographical distribution of general practitioners in the NHS who qualified medically in South Asia and to project their numbers as they retire. DESIGN: Retrospective analysis of yearly data and projection of future trends. SETTING: England and Wales. SUBJECTS: General practitioners who qualified medically in the countries of Bangladesh, India, Pakistan, and Sri Lanka and who were practising in the NHS on 1 October 1992. MAIN OUTCOME MEASURES: Proportion and age of general practitioners who qualified in South Asia by health authority; the Benzeval and Judge measure of population need at the health authority level. RESULTS: 4192 of 25 333 (16.5%) of all unrestricted general practitioners practising full time on 1 October 1992 qualified in South Asian medical schools. The proportion varied by health authority from 0.007% to 56.5%. Roughly two thirds who were practising in 1992 will have retired by 2007; in some health authorities this will represent a loss of one in four general practitioners. The practices that these doctors will leave seem to be in relatively deprived areas as measured by deprivation payments and a health authority measure of population need. CONCLUSION: Many general practitioners who qualified in South Asian medical schools will retire within the next decade. The impact will vary greatly by health authority. Those health authorities with the greatest number of such doctors are in some of the most deprived areas in the United Kingdom and have experienced the most difficulty in filling vacancies. Various responses will be required by workforce planners to mitigate the impact of these retirements.

Authors
Taylor, DH; Esmail, A
MLA Citation
Taylor, DH, and Esmail, A. "Retrospective analysis of census data on general practitioners who qualified in South Asia: who will replace them as they retire?." BMJ 318.7179 (January 30, 1999): 306-310.
PMID
9924060
Source
pubmed
Published In
BMJ (Clinical research ed.)
Volume
318
Issue
7179
Publish Date
1999
Start Page
306
End Page
310

Effects of admission to a teaching hospital on the cost and quality of care for Medicare beneficiaries.

BACKGROUND AND METHODS: We studied the effects of admission to a teaching hospital on the cost and quality of care for patients covered by Medicare (age, 65 years old or older). We used data from the National Long Term Care Survey and merged them with Medicare claims data. We selected the first hospitalization for hip fracture (802 patients), stroke (793), coronary heart disease (1007), or congestive heart failure (604) occurring between January 1, 1984 and December 31, 1994, and calculated all Medicare payments for inpatient and outpatient care during the six-month period after admission. Survival was assessed through 1995. Hospitals were classified as major or minor teaching hospitals (with minor hospitals defined as those in which the number of residents per bed was less than the median number for all teaching hospitals) or as private nonprofit, government (i.e., public), or private for-profit hospitals. RESULTS: Medicare payments for the six-month period after hospitalization were highest for patients initially admitted to teaching hospitals for the treatment of hip fracture, stroke, or coronary heart disease and for patients initially admitted to for-profit hospitals for the treatment of congestive heart failure. As compared with payments to for-profit hospitals, payments to major teaching hospitals for hip fracture were significantly higher, payments to government hospitals for coronary heart disease were lower, and payments to government and nonprofit hospitals for congestive heart failure were lower. After adjustment for patients' characteristics and social subsidies, major teaching hospitals had the lowest mortality rates (hazard ratio for death, 0.75, as compared with for-profit hospitals; 95 percent confidence interval, 0.62 to 0.91). For individual conditions, the only significant survival advantage associated with admission to major teaching hospitals was for hip fractures (hazard ratio, 0.54, as compared with for-profit hospitals; 95 percent confidence interval, 0.37 to 0.79). CONCLUSIONS: Although admission to a major teaching hospital may be associated with increased costs to the Medicare program, overall survival for patients with the common conditions we studied was better at these hospitals, especially for patients with hip fractures.

Authors
Taylor, DH; Whellan, DJ; Sloan, FA
MLA Citation
Taylor, DH, Whellan, DJ, and Sloan, FA. "Effects of admission to a teaching hospital on the cost and quality of care for Medicare beneficiaries." N Engl J Med 340.4 (January 28, 1999): 293-299.
PMID
9920955
Source
pubmed
Published In
The New England journal of medicine
Volume
340
Issue
4
Publish Date
1999
Start Page
293
End Page
299
DOI
10.1056/NEJM199901283400408

Does Where You are Admitted Make a Difference? An Analysis of Medicare Data

Authors
Sloan, FA; Picone, G; Taylor, DH; Chou, S-Y
MLA Citation
Sloan, FA, Picone, G, Taylor, DH, and Chou, S-Y. "Does Where You are Admitted Make a Difference? An Analysis of Medicare Data." (January 1999).
Source
ssrn
Publish Date
1999

Timely Flood Aid from N.C.’s Refund

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Timely Flood Aid from N.C.’s Refund." (1999).
Source
manual
Publish Date
1999

Does Ownership Affect the Cost of Medicare?

Authors
Sloan, FA; Donald H Taylor, J
MLA Citation
Sloan, FA, and Donald H Taylor, J. "Does Ownership Affect the Cost of Medicare?." Medicare Reform: Issues and Answers. Ed. AJ Rettenmaier and TR Saving. Chicago: The University of Chicago Press, 1999. 99-130.
Source
manual
Publish Date
1999
Start Page
99
End Page
130

Does Where You are Admitted Make A Difference?

Authors
Sloan, FA; Picone, G; Donald H Taylor, J; Chou, S-Y
MLA Citation
Sloan, FA, Picone, G, Donald H Taylor, J, and Chou, S-Y. "Does Where You are Admitted Make A Difference?." Frontiers of Health Policy Research. Ed. AM Garber. Cambridge, MA: National Bureau of Economic Research and MIT Press, 1999. 1-27.
Source
manual
Volume
2
Publish Date
1999
Start Page
1
End Page
27

End of Life Care: Private and Public Choices

Authors
Sloan, FA; Taylor, DH; Jr,
MLA Citation
Sloan, FA, Taylor, DH, and Jr, . "End of Life Care: Private and Public Choices." JAMA 282.21 (1999): 2078-. (Academic Article)
Source
manual
Published In
JAMA
Volume
282
Issue
21
Publish Date
1999
Start Page
2078

Do targeted efforts for the rural underserved help kill comprehensive reform?

There has been a shift during the past 60 years from a broad notion of the entire nation as underserved to a more focused effort to identify particular areas (often rural) thought to be underserved. This approach was formalized with the advent of the war on poverty. This focused approach has been cemented during the past 30 years, in part by the success of various federal health center programs that have remained funded during this period in spite of opposition. This paper concludes that the consensus view that rural underserved areas represent an "exception" phenomenon that is properly addressed with special responses (organizations or physicians) has had two major effects: (1) the political survivability of focused programmatic responses (such as Community Health Centers) has been enhanced; and (2) the existence of an "elastic net" policy network to advocate for the expansion of such remedial efforts may play a contributory role in helping to defeat comprehensive health reform.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Do targeted efforts for the rural underserved help kill comprehensive reform?." J Rural Health 15.1 (1999): 55-60. (Review)
PMID
10437331
Source
pubmed
Published In
The Journal of Rural Health
Volume
15
Issue
1
Publish Date
1999
Start Page
55
End Page
60

Cost and Outcomes of Stroke and Hip Fracture: Rising Costs but Better Outcomes?

Authors
Sloan, FA; Taylor, DH; Jr, ; Picone, G
MLA Citation
Sloan, FA, Taylor, DH, Jr, , and Picone, G. "Cost and Outcomes of Stroke and Hip Fracture: Rising Costs but Better Outcomes?." American Journal of Public Health 89.6 (1999): 935-937. (Academic Article)
Source
manual
Published In
American Journal of Public Health
Volume
89
Issue
6
Publish Date
1999
Start Page
935
End Page
937

Effects of Admission to a Teaching Hospital on Cost and Quality of Care: Evidence from Medicare

Authors
Taylor, DH; Whellan, D; Sloan, FA
MLA Citation
Taylor, DH, Whellan, D, and Sloan, FA. "Effects of Admission to a Teaching Hospital on Cost and Quality of Care: Evidence from Medicare." New England Journal of Medicine 318.340 (1999): 293-299. (Academic Article)
Source
manual
Published In
New England Journal of Medicine
Volume
318
Issue
340
Publish Date
1999
Start Page
293
End Page
299

Does ownership affect the cost of Medicare?

Authors
Sloan, FA; Taylor, DH
MLA Citation
Sloan, FA, and Taylor, DH. "Does ownership affect the cost of Medicare?." 1999.
Source
wos-lite
Published In
MEDICARE REFORM: ISSUES AND ANSWERS
Volume
1
Publish Date
1999
Start Page
99
End Page
129

Effects of teaching hospitals on cost and quality of care: Evidence from Medicare

Authors
Whellan, DJ; Taylor, DH; Sloan, FA
MLA Citation
Whellan, DJ, Taylor, DH, and Sloan, FA. "Effects of teaching hospitals on cost and quality of care: Evidence from Medicare." CIRCULATION 98.17 (October 27, 1998): 478-478.
Source
wos-lite
Published In
Circulation
Volume
98
Issue
17
Publish Date
1998
Start Page
478
End Page
478

The natural life of policy indices: geographical problem areas in the U.S. and U.K.

In spite of many fundamental differences between the health systems in the U.S. and U.K., each has pursued a policy of identifying geographical small-areas believed to have inadequate primary care physicians given local health care needs. The magnitude of the problems in such areas differ in the U.S. and U.K. leading to idiosyncratic policy responses that are dictated by overall health system realities. However, there are several common themes identified in this comparative study: goals for remedial health policy are often unclear, making evaluation difficult; in the absence of conceptual clarity, a consensus-based approach of identifying existing and widely available variables to designate areas has been used to identify geographical problem areas; there are widespread concerns that the present indices used to implement policy are inappropriate, but no alternative index has been adopted. The paper concludes that clarifying goals for remedial health policy is key if the effectiveness of such policy is to be improved. Guidelines for assessing the usefulness of existing and future indices used to designate areas as eligible for resources as a part of this type of small-area remedial policy are developed from this U.S./U.K. comparison.

Authors
Taylor, DH
MLA Citation
Taylor, DH. "The natural life of policy indices: geographical problem areas in the U.S. and U.K." Soc Sci Med 47.6 (September 1998): 713-725.
PMID
9690819
Source
pubmed
Published In
Social Science & Medicine
Volume
47
Issue
6
Publish Date
1998
Start Page
713
End Page
725

Hospital Conversions Manual for North and South Carolina

Authors
Conover, C; Haverkamp, H; Sloan, FA; Donald H Taylor, J
MLA Citation
Conover, C, Haverkamp, H, Sloan, FA, and Donald H Taylor, J. "Hospital Conversions Manual for North and South Carolina." (August 1998).
Source
manual
Publish Date
1998

General practitioner turnover and migration in England 1990-94.

BACKGROUND: In tandem with fears about a GP workforce crisis, increasing attention is being focused on the supply and distribution of primary care services: on general practitioners in particular. Differential turnover and migration across health authority boundaries could lead to a maldistribution of GPs, yet comprehensive studies of GP turnover are non-existent. AIM: To quantify general practitioner (GP) turnover and migration in England from 1990 to 1994. METHOD: Yearly data from 1 October 1990 to 1 October 1994 were collected on GPs in England practising full time, including average yearly turnover, rates of entry to and exit from general practice, and net migration among GPs. All were calculated at the family health service authority (now the new health authorities) level. RESULTS: Average yearly GP turnover ranges from 2.9% in Shropshire to 7.8% in Kensington, Chelsea and Westminster; turnover is associated with deprivation and high-need areas. Migration of GPs across health authority borders was rare. Entry and exit rates were also positively related to measures of deprivation and need. Relatively underprovided health authorities lost 23 GPs over the study period as a result of migration; relatively overprovided ones gained three. CONCLUSION: Turnover is driven primarily by exits from general practice and is related to deprivation and high need. Retention appears to be the main problem in ensuring an adequate GP supply in relatively deprived and underprovided health authorities.

Authors
Taylor, DH; Leese, B
MLA Citation
Taylor, DH, and Leese, B. "General practitioner turnover and migration in England 1990-94." Br J Gen Pract 48.428 (March 1998): 1070-1072.
PMID
9624750
Source
pubmed
Published In
British Journal of General Practice
Volume
48
Issue
428
Publish Date
1998
Start Page
1070
End Page
1072

Partnership Changes in General Practice, 1990-1994

Authors
Taylor, DH; Leese, B
MLA Citation
Taylor, DH, and Leese, B. "Partnership Changes in General Practice, 1990-1994." Journal of Public Health Medicine 19 (1997): 341-346. (Academic Article)
Source
manual
Published In
Journal of Public Health Medicine
Volume
19
Publish Date
1997
Start Page
341
End Page
346

Recruitment, Retention, and Time Commitment Change of General Practitioner's in England and Wales: 1990-94

Authors
Taylor, DH; Leese, B
MLA Citation
Taylor, DH, and Leese, B. "Recruitment, Retention, and Time Commitment Change of General Practitioner's in England and Wales: 1990-94." British Medical Journal (BMJ) 314 (1997): 1806-1810. (Academic Article)
Source
manual
Published In
British Medical Journal (BMJ)
Volume
314
Publish Date
1997
Start Page
1806
End Page
1810

Partnership changes in English general practice from 1990 to 1994

Background. The objective of this study was to quantify the rate of partnership change among general practitioners (GPs) in the National Health Service (NHS) in England from 1990 to 1994. Methods. Time series data on English GPs were analysed on 1 October for the years 1990-1994. The main outcome measures include: (1) proportion of GPs practising in an unchanged partnership from 1 October 1990 to 1 October 1994; (2) proportion of partnerships that were unchanged over the study period; (3) the average yearly rate of partnership changes for England and per Family Health Service Authority (FHSA), calculated using both the individual GP and the practice as the unit of analysis. Results. A total of 6532 (27.1 per cent) of the 24,107 unrestricted GPs practising full time on 1 October 1990 were still practising in the identical partnership on 1 October 1994; 3539 (35.7 per cent) of the 9918 practices in England were unchanged over the same period. The average yearly partnership change rate for all England was 23.1 per cent when calculated using the individual GP as the unit of analysis, and 23.4 per cent when calculated using the practice as the unit of analysis. There is threefold variation found in the average yearly partnership change rate by FHSA, with similar rank ordering of health authorities when using either the individual GP or practice as unit of analysis. Conclusions. Changes in partnerships are commonplace. The possible influence of such changes on primary care in the NHS should be further investigated.

Authors
Jr, DHT; Leese, B
MLA Citation
Jr, DHT, and Leese, B. "Partnership changes in English general practice from 1990 to 1994." Journal of Public Health Medicine 19.3 (1997): 341-346.
PMID
9347461
Source
scival
Published In
Journal of public health medicine
Volume
19
Issue
3
Publish Date
1997
Start Page
341
End Page
346

Recruitment, retention, and time commitment change of general practitioners in England and Wales, 1990-4: A retrospective study

Objectives: To describe the recruitment and retention of general practitioners and changes in their time commitment from 1 October 1990 to 1 October 1994. Design: Retrospective analysis of yearly data. Setting: England and Wales. Subjects: General practitioners in unrestricted practice. Main outcome measures: Numbers of general practitioners moving into and out of general practice; proportion of general practitioners practising less than full time; proportion of general practitioners having unchanged time commitment over the study period; and proportion of general practitioners leaving general practice in 1991 who were subsequently practising in 1994. Results: Numbers of general practitioners entering general practice (1565 in 1990, 1400 in 1994) fell over the study period as did the numbers leaving general practice (1488 in 1990, 1115 in 1994). The net effect was an increase in both the total and full time equivalent general practitioners practising from 1 October 1990 (26,757 full time equivalents) to 1 October 1994 (21,063 full time equivalents). Numbers of general practitioners practising full time were decreasing whereas part time practice was increasing; women were more likely to practise part time. 35.5% (43/121) of women practising full time and 17.8% (24/135) of men practising full time who left practice in 1991 were practising again in 1994. Conclusion: Simply using total numbers of general practitioners or net increase to describe workforce trends masks much movement in and out of general practice and between differing time commitments. Recruitment and retention issues need to be separated if reasonable policies are to be developed to assure the necessary general practitioner workforce for a primary care led NHS.

Authors
Jr, DHT; Leese, B
MLA Citation
Jr, DHT, and Leese, B. "Recruitment, retention, and time commitment change of general practitioners in England and Wales, 1990-4: A retrospective study." British Medical Journal 314.7097 (1997): 1806-1810.
PMID
9224085
Source
scival
Published In
British Medical Journal
Volume
314
Issue
7097
Publish Date
1997
Start Page
1806
End Page
1810

Why Should It Take A Hurricane Fran?

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Why Should It Take A Hurricane Fran?." (1996).
Source
manual
Publish Date
1996

Examining Alternative Measures of Underservice

Authors
Thomas C Ricketts, III; Donald H Taylor, J
MLA Citation
Thomas C Ricketts, III, and Donald H Taylor, J. "Examining Alternative Measures of Underservice." (July 1995).
Source
manual
Publish Date
1995

Executive Summary: Examining Alternative Measures of Rural Underservice

Authors
Thomas C Ricketts, III; Donald H Taylor, J
MLA Citation
Thomas C Ricketts, III, and Donald H Taylor, J. "Executive Summary: Examining Alternative Measures of Rural Underservice." (June 1995).
Source
manual
Publish Date
1995

The Measurement of Underservice and Provider Shortage in the United States: A Policy Analysis

Authors
Taylor, DH; Thomas C Ricketts, III; Kolimaga, J; Howard, HA
MLA Citation
Taylor, DH, Thomas C Ricketts, III, Kolimaga, J, and Howard, HA. "The Measurement of Underservice and Provider Shortage in the United States: A Policy Analysis." (June 1995).
Source
manual
Publish Date
1995

Alternative Measures of Medical Underservice: A Proposal and Assessment

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Alternative Measures of Medical Underservice: A Proposal and Assessment." (April 1995).
Source
manual
Publish Date
1995

Review of My Own Country

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Review of My Own Country." The Journal of Health Care for the Poor and Underserved 6 (1995): 41-41. (Review)
Source
manual
Published In
The Journal of Health Care for the Poor and Underserved
Volume
6
Publish Date
1995
Start Page
41
End Page
41

Rural Health Care Reform Is A Matter of Will, Not Ways

Authors
Taylor, DH
MLA Citation
Taylor, DH. "Rural Health Care Reform Is A Matter of Will, Not Ways." (1995).
Source
manual
Publish Date
1995

Using logistic regression to make county-level estimates of the medically uninsured in North Carolina

Often, policy analysts are asked to produce data for which there are no universally accepted methods. Policymakers and legislators are continually searching for accurate estimates of the magnitude of the problem with which to inform their debate, but often need the estimates within a short period of time - too short to allow large, population-based sample surveys. This means that such estimates must be produced from data that may lack the specificity sought by policymakers and legislators, using techniques not perfectly suited for the analysis. The recent focus on health care financing policies has created a situation where estimates of the number of medically uninsured persons are key to decision-making about coverage policies. This article describes the use of the 1992 Current Population Survey and logistic regression analysis to explain the determinants of women of childbearing age in North Carolina without medical insurance, and to develop county-level estimates of their population. This is an example of using logistic regression as a tool for prediction and projection of data crucial to the policymaking process as well as adapting a method normally used in the academic environment to the policy world.

Authors
III, TCR; Jr, DHT; Savitz, LA
MLA Citation
III, TCR, Jr, DHT, and Savitz, LA. "Using logistic regression to make county-level estimates of the medically uninsured in North Carolina." Policy Studies Review 14.3-4 (1995): 323-338.
Source
scival
Published In
The Review of Policy Research
Volume
14
Issue
3-4
Publish Date
1995
Start Page
323
End Page
338

The Outcomes and Costs of Care for Acute Low Back Pain Among Patients Seen by Primary Care Practitioners, Chiropractors, and Orthopedic Surgeons

Authors
Carey, TS; Garrett, J; Jackman, A; McLaughlin, C; Fryer, J; Smucker, DS; Project, TNCBP
MLA Citation
Carey, TS, Garrett, J, Jackman, A, McLaughlin, C, Fryer, J, Smucker, DS, and Project, TNCBP. "The Outcomes and Costs of Care for Acute Low Back Pain Among Patients Seen by Primary Care Practitioners, Chiropractors, and Orthopedic Surgeons." New England Journal of Medicine 333 (1995): 913-917. (Academic Article)
Source
manual
Published In
New England Journal of Medicine
Volume
333
Publish Date
1995
Start Page
913
End Page
917

Defining Underservice and Physician Shortage Areas in Historical and Future Contexts

Authors
Taylor, DH; Thomas C Ricketts, III; Kolimaga, J
MLA Citation
Taylor, DH, Thomas C Ricketts, III, and Kolimaga, J. "Defining Underservice and Physician Shortage Areas in Historical and Future Contexts." (April 1994).
Source
manual
Publish Date
1994

Urban/Rural Differences in Care Seeking for Adults With Acute Severe Low Back Pain

Authors
Joines, JD; Donald H Taylor, J; Garrett, JM; Ricketts, TC; Carey, TS
MLA Citation
Joines, JD, Donald H Taylor, J, Garrett, JM, Ricketts, TC, and Carey, TS. "Urban/Rural Differences in Care Seeking for Adults With Acute Severe Low Back Pain." (April 1994).
Source
manual
Publish Date
1994

Regional and Urban-Rural Differences in Care-Seeking and Choice of Provider for Adults with Acute Low Back Pain

Authors
Joines, JD; Donald H Taylor, J; Thomas C Ricketts, III; Carey, TS
MLA Citation
Joines, JD, Donald H Taylor, J, Thomas C Ricketts, III, and Carey, TS. "Regional and Urban-Rural Differences in Care-Seeking and Choice of Provider for Adults with Acute Low Back Pain." Journal of General Internal Medicine 9 (1994): 57-57.
Source
manual
Published In
Journal of General Internal Medicine
Volume
9
Publish Date
1994
Start Page
57
End Page
57

Increasing Obstetrical Care Access to the Rural Poor

Authors
Taylor, DH; Thomas, C; Ricketts, III
MLA Citation
Taylor, DH, Thomas, C, and Ricketts, III. "Increasing Obstetrical Care Access to the Rural Poor." Journal of Health Care for the Poor and Underserved 4 (1994): 27-35. (Academic Article)
Source
manual
Published In
Journal of Health Care for the Poor and Underserved
Volume
4
Publish Date
1994
Start Page
27
End Page
35

Study of Health Insurance Coverage for Prenatal and Maternal Delivery Services in North Carolina

Authors
Thomas C Ricketts, III; Kolimaga, J; Donald H Taylor, J; Savitz, LA
MLA Citation
Thomas C Ricketts, III, Kolimaga, J, Donald H Taylor, J, and Savitz, LA. "Study of Health Insurance Coverage for Prenatal and Maternal Delivery Services in North Carolina." (1993).
Source
manual
Publish Date
1993

Helping Nurse-Midwives Provide Obstetrical Care

Authors
Taylor, DH; Thomas, C; Ricketts, III
MLA Citation
Taylor, DH, Thomas, C, and Ricketts, III. "Helping Nurse-Midwives Provide Obstetrical Care." American Journal of Public Health 83 (1993): 904-905. (Academic Article)
Source
manual
Published In
American Journal of Public Health
Volume
83
Publish Date
1993
Start Page
904
End Page
905

Helping nurse-midwives provide obstetrical care in rural North Carolina

Authors
Jr, DHT; III, TCR
MLA Citation
Jr, DHT, and III, TCR. "Helping nurse-midwives provide obstetrical care in rural North Carolina." American Journal of Public Health 83.6 (1993): 904-905.
PMID
8498634
Source
scival
Published In
American Journal of Public Health
Volume
83
Issue
6
Publish Date
1993
Start Page
904
End Page
905

Increasing obstetrical care access to the rural poor.

Rising malpractice insurance rates have led to a decrease in the number of physicians who provide rural obstetrical care. North Carolina has responded with the Rural Obstetrical Care Incentive (ROCI) Program, which provides up to $6,500 per year to physicians who provide obstetrical care to the rural poor in conjunction with a local health department. This study finds some evidence that the program has led to an increase in the satisfaction that physician participants feel toward the prenatal care available at the local health department; that participants are increasing their provision of obstetrical care to Medicaid patients compared to other physicians in the state; and that the percentage of women delivering after receiving inadequate prenatal care is decreasing in the original ROCI counties, at a time when other rural counties are experiencing an increase in this measure. Other states should consider the ROCI program as one aspect of a rural health strategy.

Authors
Jr, DHT; 3rd, TCR
MLA Citation
Jr, DHT, and 3rd, TCR. "Increasing obstetrical care access to the rural poor." Journal of health care for the poor and underserved 4.1 (1993): 9-20.
PMID
8448280
Source
scival
Published In
Journal of health care for the poor and underserved
Volume
4
Issue
1
Publish Date
1993
Start Page
9
End Page
20

A State's Response to the Liability Crisis: North Carolina's Rural Obstetrical Care Incentive (ROCI) Program

Authors
Taylor Thomas, DH; Ricketts, C; Jess, III; Berman Jane, L; Kolimaga, T
MLA Citation
Taylor Thomas, DH, Ricketts, C, Jess, III, Berman Jane, L, and Kolimaga, T. "A State's Response to the Liability Crisis: North Carolina's Rural Obstetrical Care Incentive (ROCI) Program." Public Health Reports (1992): 523-529. (Academic Article)
Source
manual
Published In
Public Health Reports
Publish Date
1992
Start Page
523
End Page
529

One state's response to the malpractice insurance crisis: North Carolina's Rural Obstetrical Care Incentive Program

In the period 1985-89, there was a severe drop in obstetrical services in rural areas of North Carolina, partly because of rising malpractice insurance rates. The State government responded with the Rural Obstetrical Care Incentive (ROCI) Program that provides a malpractice insurance subsidy of up to $6,500 per participating physician per year. Enacted into law in 1988, the ROCI Program was expanded in 1991, making certified nurse midwives eligible to receive subsidies of up to $3,000 per year. To participate, practitioners must provide obstetrical care to all women, regardless of their ability to pay for services. Total funding for the program has increased from $240,000 to $840,000, in spite of extreme budgetary constraints faced by the State. The program and how its implementation has maintained or increased access to obstetrical care in participating counties are described on the basis of site visits to local health departments in participating counties and data from the North Carolina Division of Maternal and Child Health. The program is of significance to policy makers nationwide as both a response to rising malpractice insurance rates and reduced access to obstetrical care in rural areas, and as an innovative, nontraditional State program in which the locus of decision making is at the county level.

Authors
Jr, DHT; III, TCR; Berman, JL; Kolimaga, JT
MLA Citation
Jr, DHT, III, TCR, Berman, JL, and Kolimaga, JT. "One state's response to the malpractice insurance crisis: North Carolina's Rural Obstetrical Care Incentive Program." Public Health Reports 107.5 (1992): 523-529.
PMID
1410232
Source
scival
Published In
Public Health Reports
Volume
107
Issue
5
Publish Date
1992
Start Page
523
End Page
529

A Response to the Liability Crisis: The First Three Years of North Carolina’s Rural Obstetrical Care Incentive (ROCI) Program

Authors
Taylor, DH; Thomas C Ricketts, III; Langholz, R
MLA Citation
Taylor, DH, Thomas C Ricketts, III, and Langholz, R. "A Response to the Liability Crisis: The First Three Years of North Carolina’s Rural Obstetrical Care Incentive (ROCI) Program." (November 1991).
Source
manual
Publish Date
1991
Show More