CARDIOVASCULAR DISEASE: Measures of Medical Treatment 2

A recent trial comparing medical and surgical management of elderly patients with coronary artery disease reported improved quality of life at one year for both treatment arms (Pfisterer, Buser et al. 2003), suggesting that treatment likely reduces disability in the elderly population. However, no studies to date have estimated the effect of increased use of…

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CARDIOVASCULAR DISEASE: Conclusion 2

Although treatment costs are approximately twice as high for respondents receiving appropriate treatments, these costs may be offset by lower yearly spending in subsequent years among survivors. A previous study of 1982 and 1984 NLTCS respondents found annual per capita spending by Medicare for respondents without any ADL or IADL limitations was approximately $3,275, compared…

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CARDIOVASCULAR DISEASE: Conclusion

To forecast mortality beyond the 10 year observation window, we assume that the mortality hazard estimated in 1997-99 prevails in all subsequent years. Making this assumption, we estimate that those not disabled in 1989 have an average life expectancy of 7.8 years while those disabled in 1989 were expected to live only another 5.1 years…

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CARDIOVASCULAR DISEASE: Other Circulatory Diseases

In the model with demographic and health characteristics, circulatory disease patients in the 1994 survey were significantly less likely to be disabled and dead at follow-up compared to the 1984 survey (Table 9). When we include treatment covariates, we explain approximately 18% of the association between 1994 survey year and death, and the 1994 survey…

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CARDIOVASCULAR DISEASE: Ischemic Heart Disease

As described in more detail in (Stewart, Landrum et al. 2006), treatment covariates explain between 50 and 70% of the association between disability and death over time in the IHD cohort. Relevant procedures were significantly associated with death, but not disability, and pharmaceutical care was significantly associated with disability but not death Stroke patients in…

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CARDIOVASCULAR DISEASE: Estimation Results

Table 5 shows demographic characteristics of our cohort by year of baseline survey. The proportion of respondents disabled at baseline declined over time, from 32% in 1984 to 25.9% in 1994. This 6 percentage point decline in disability at baseline is consistent with other analyses using the NLTCS (Manton and Gu 2001). In addition, there…

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CARDIOVASCULAR DISEASE: Measures of Medical Treatment

We use several measures of medical care to predict disability. The first variable is the share of people who receive surgical interventions. To define relevant procedures, we identify treatments for each specific diagnosis that the medical literature has identified as being efficacious (generally in reducing mortality) for at least some subsets of patients with that…

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