Absence Of Cancer Diagnosis And Treatment In Elderly Medicaid-Insured Nursing Home Residents

UroToday.com- A study in the January 2008 issue of the Journal of the National Cancer Institute suggests that Medicaid patients in nursing home care receive limited cancer services. While the prevalence of cancer in nursing home patients is 1 in 10, according to Dr. Bradley and coauthors this population has received little attention in outcomes research.

In the U.S, Medicaid is the predominant payer for long-term residential nursing home care. These patients often have low income, frail, and more than 30% of them require assistance to perform 3 or more activities of daily living. It is reported that nursing home staff may not effectively recognize and treat cancer. The researchers used statewide Medicaid and Medicare data merged with the Michigan Tumor Registry to identify a study sample of patients with a first primary cancer diagnosis. Tumor registry patients were matched to the state Medicare Denominator file for the years 1996-2000 and all claims for inpatient, outpatient, physician, and hospice services were identified. Those with at least one year of claims history before the month of diagnosis were selected, as this permitted an estimate of patients' comorbidity burden. The researchers calculated odds ratios for late or invasive but unknown stage of cancer, death within 3 months of diagnosis, receipt of hospice services, and receipt of cancer-directed surgery.