Mary Beth Landrum

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PURPOSE To characterize the aggressiveness of end-of-life cancer treatment for older adults on Medicare, and its relationship to the availability of healthcare resources. PATIENTS AND METHODS We analyzed Medicare claims of 28,777 patients 65 years and older who died within 1 year of a diagnosis of lung, breast, colorectal, or other gastrointestinal cancer(More)
The purpose of this article is to review the literature and update analyses pertaining to the aggressiveness of cancer care near the end of life. Specifically, we will discuss trends and factors responsible for chemotherapy overuse very near death and underutilization of hospice services. Whether the concept of overly aggressive treatment represents a(More)
PURPOSE To describe desired and actual roles in treatment decision making among patients with early-stage breast cancer, identify how often patients' actual roles matched their desired roles, and examine whether matching of actual and desired roles was associated with type of treatment received and satisfaction. PATIENTS AND METHODS We surveyed 1,081(More)
PURPOSE We examined the health-related quality of life (QOL) of a cohort of older women with breast cancer after their diagnosis. PATIENTS AND METHODS Six hundred ninety-one women aged 65 years and older were interviewed approximately 3 months after breast cancer surgery and two additional times in the following year using standardized QOL measures.(More)
OBJECTIVES To assess the physical and mental health status of older long-term cancer survivors. DESIGN Cohort study using propensity score methods to control for baseline differences between cancer survivors and controls. SETTING General community population in the United States. PARTICIPANTS Nine hundred sixty-four cancer patients who had survived(More)
PURPOSE Many older breast cancer survivors do not undergo annual mammography despite guideline recommendations. We identified factors associated with underuse of surveillance mammography and examined whether variation was explained by differences in follow-up care. PATIENTS AND METHODS We used Surveillance, Epidemiology, and End Results-Medicare data to(More)
We determined whether adherence to recommendations for coronary angiography more than 12 h after symptom onset but prior to hospital discharge after acute myocardial infarction (AMI) resulted in better survival. Using propensity scores, we created a matched retrospective sample of 19,568 Medicare patients hospitalized with AMI during 1994-1995 in the United(More)
PURPOSE Guidelines recommend against routine surveillance testing for women who have had breast cancer. We described follow-up care for breast cancer survivors, examined how surveillance testing varies by the types of physicians seen, and assessed changes in testing rates over time. METHODS Using Surveillance, Epidemiology, and End Results-Medicare data,(More)
National effort is currently directed toward developing and disseminating comparative information involving both outcomes and processes of care for health care providers. Univariate provider-specific comparative indices based on posterior summaries as well as indices based on maximum likelihood estimates have been developed for use in the cross-sectional(More)
1 During the past two decades, several public and private organizations have initiated programs to report publicly on the quality of medical care provided by specific hospitals and physicians. These programs have sparked broad debate among economists and policy makers. At issue is the question of whether, and to what extent, these " report card " programs(More)