Health-related quality of life of cancer and noncancer patients in Medicare managed care

Abstract

Background: Data from the Health Care Financing Administration's (HCFA) Medicare Health Outcomes Survey (MHOS) of patients enrolled in managed care services through Medicare were analyzed. The MHOS provided baseline estimates of quality of life of cancer survivors in comparison to a frequency age-matched cohort of noncancer patients.

Method: In 1998, the MHOS was mailed to a random sample of 279,135 beneficiaries. Completed surveys were received from 167,096 respondents (60%). Some 22,747 respondents who had been diagnosed with cancer were frequency age matched to an equal number of noncancer patients.

Results: Cancer survivors had statistically significantly poorer scores than noncancer patients on all eight subscales as well as on the Physical Component and Mental Component summary measures of the Medical Outcomes Study Short Form-36 (MOS SF-36). Comparisons by type and number of cancers for which an individual was currently in treatment showed lowest quality of life for those in treatment for lung carcinoma, followed by those who were in treatment for more than one type of cancer.

Conclusion: The data suggest that cancer shows negative effects on health-related quality of life that are not explainable by simple effects of age because frequency age-matched cancer survivors had statistically significantly lower scores on all 10 scores of the MOS SF-36. Effect sizes are evaluated to determine the clinical significance of these differences in health-related quality of life. The MHOS offers useful data for planning and improving cancer policy and programs.