Electronic Theses and Dissertations

Date

2019

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Epidemiology

Committee Chair

Xinhua Yu

Committee Member

Satish Kedia

Committee Member

Fawaz Mzayek

Committee Member

SangNam Ahn

Abstract

The purpose of this dissertation was to evaluate the impact of physical and functional limitations among older cancer survivors and its effect on healthcare utilization and mortality among them. The Medicare Current Beneficiary Survey (MCBS) is nationally representative longitudinal study of older Medicare beneficiaries. Physical Limitations (PL), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) were measured on a five-point scale. MCBS data from 2005 to 2013 were used in this study. Propensity score weighting was developed using logistic regressions. Design-based descriptive analysis and logistic models with adjusted survey weights were performed. Logistic and Poisson regression models were developed for hospitalization, re-hospitalization and mortality rates. Cancer survivors had higher functional limitations compared to non-cancer individuals. After adjusting for socio-demographic characteristics and cancer survivors were more likely to have physical limitations (OR: 1.62, 95% CI: 1.28-2.06). There was a one-year lag in functional limitations resulting in one-year loss of physical capabilities among cancer survivors compared to non-cancer beneficiaries. Older cancer survivors with physical and functional limitations had higher rate of emergency department visits than those without limitations (PL: 21.8%vs.17%, aOR:1.72, 95% CI: 1.262.35, p

Comments

Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest

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