The quality of end-of-life care was assessed in disadvantaged men prospectively enrolled in a public assistance program. That end-of-life care would be aggressive, moreso than recommended by quality-of-care guidelines, was hypothesized.
The authors compared the types of treatments prostate cancer patients received from county hospitals and private providers as part of a statewide public assistance program in a cohort study of 559 men enrolled in a state-funded program for low-income patients known as Improving Access, Counseling, and Treatment for Californians With Prostate Cancer (IMPACT).
Radiation or surgery can lead to significant dysfunction or distress in the urinary, sexual, or bowel domains. Hence, the simultaneous consideration of both quality and quantity of life improves medical decision making for these men.
Decision making for treatment of localized prostate cancer is often guided by therapeutic side-effect profiles. The authors sought to assess health-related quality-of-life outcomes for patients 48 months after treatment for localized prostate cancer. Men treated for localized prostate cancer were evaluated before treatment and at 11 intervals during the 48 months after intervention. Changes in mean health-related quality-of-life scores and the probability of regaining baseline levels of health-related quality of life were compared between treatment groups.
Economic evaluations of health care can be used by policy makers and other decision makers to compare the cost effectiveness of different treatment strategies and to make decisions about the allocation of scarce resources, such as dollars spent on health care.
The RAND Summer Institute consists of conferences addressing critical issues facing our aging population. Select sessions from the 15th Annual RAND Summer Institute, held July 7-10, 2008 in Santa Monica, California, are available for online viewing.
Quantifies the value of recent gains in cancer survival and analyzes the distribution of value among various stakeholders. Calculations suggest that from the patient's point of view, the rate of return on R&D investments has been substantial.