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Identifying Predictors of Longitudinal Decline in the Level of Medical Care Received by Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study
Author(s) -
Casillas Jacqueline,
Oeffinger Kevin C.,
Hudson Melissa M.,
Greenberg Mark L.,
Yeazel Mark W.,
Ness Kirsten K.,
Henderson Tara O.,
Robison Leslie L.,
Armstrong Gregory T.,
Liu Qi,
Leisenring Wendy,
Yasui Yutaka,
Nathan Paul C.
Publication year - 2015
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12282
Subject(s) - medicine , childhood cancer , longitudinal study , cohort study , retrospective cohort study , cohort , cancer , relative risk , incidence (geometry) , health care , pediatrics , confidence interval , physics , pathology , optics , economics , economic growth
Objectives Characterize longitudinal changes in the use of medical care in adult survivors of childhood cancer. Data Sources The Childhood Cancer Survivor Study, a retrospective cohort study of 5+ year survivors of childhood cancer. Study Design Medical care was assessed at entry into the cohort (baseline) and at most recent questionnaire completion. Care at each time point was classified as no care, general care, or survivor‐focused care. Data Collection There were 6,176 eligible survivors. Multivariable models evaluated risk factors for reporting survivor‐focused care or general medical care at baseline and no care at follow‐up; and survivor‐focused care at baseline and general care at follow‐up. Principal Findings Males ( RR , 2.3; 95 percent CI 1.8–2.9), earning <$20,000/year ( RR , 1.6; 95 percent CI 1.2–2.3) or ≤high school education ( RR , 2.5; 95 percent CI 1.6–3.8 and RR 2.0; 95 percent CI 1.5–2.7 for