Abstract
Introduction
To understand associations between a new measure of illness burden and care experiences
in a large, national sample of Medicare beneficiaries surveyed before or after a cancer
diagnosis.
Materials and Methods
The SEER-CAHPS Illness Burden Index (SCIBI) was previously developed using Surveillance,
Epidemiology, and End Results (SEER)–Consumer Assessment of Healthcare Providers and
Systems (CAHPS) linked data. The SCIBI provides a standardized morbidity score based
on self- and other-reported information from 8 domains and proxies relative risk of
12-month, all-cause mortality among people surveyed before or after a cancer diagnosis.
We analyzed a population of Medicare beneficiaries (n = 116,735; 49% fee-for-service and 51% Medicare Advantage [MA]; 73% post-cancer diagnosis)
surveyed 2007–2013 to understand how their SCIBI scores were associated with 12 different
care experience measures. Frequentist and Bayesian multivariable regression models
adjusted for standard case-mix adjustors, enrollment type, timing of cancer diagnoses
relative to survey, and survey year.
Results and Discussion
SCIBl scores were associated (P < .001) in frequentist models with better ratings of Health Plan (coefficient ± standard
error: 0.33 ± 0.08) and better Getting Care Quickly scores (0.51 ± 0.09). In Bayesian
models, individuals with higher illness burden had similar results on the same two
measures and also reported reliably worse Overall Care experiences (coefficient ±
posterior SD: −0.17 ± 0.06). Illness burden may influence how people experience care
or report those experiences. Individuals with greater illness burdens may need intensive
care coordination and multilevel interventions before and after a cancer diagnosis.
Keywords
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Article info
Publication history
Published online: March 08, 2022
Accepted:
February 24,
2022
Received in revised form:
December 20,
2021
Received:
June 14,
2021
Identification
Copyright
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