Linking the Iowa Women's Health Study cohort to Medicare data: linkage results and application to hip fracture.

This study linked the Iowa Women's Health Study cohort to Medicare administrative data and assessed the value of using Medicare and survey-based sources to study hip fracture incidence. The authors used Social Security number to combine the Iowa Women's Health Study cohort Medicare enrollment and claims data for 1986-2004. Hip fractures were identified from Medicare and follow-up-mail, survey-based sources.

Correlates and consequences of venous thromboembolism: The Iowa Women's Health Study.

Objectives: We sought to document incidence, case-fatality, and recurrence rates of venous thromboembolism (VTE) in women and to explore the relationship of demographic, lifestyle, and anthropometric factors to VTE incidence.

Methods: Data from participants aged 55 to 69 years in the Iowa Women's Health Study were linked to Medicare data for 1986 through 2004 (n = 40 377) to identify hospitalized VTE patients.

Results: A total of 2137 women developed VTE, yielding an incidence rate of 4.

Risk of dementia in older breast cancer survivors: a population-based cohort study of the association with adjuvant chemotherapy.

Objectives: To assess whether there is an association between delivery of adjuvant chemotherapy to older women with breast cancer and development of dementia over time.

Design: Retrospective cohort study using Surveillance, Epidemiology, and End Results (SEER) data linked to Medicare claims data.

Setting: Women residing in geographic areas included in the SEER registry.

Managed care enrollment and chronically disabled women with breast cancer.

Objective: To assess whether managed care enrollment or healthcare utilization level among women enrolled in Medicare because of disability affects stage at diagnosis and treatment of breast cancer.

Study Design: Retrospective study using the Surveillance, Epidemiology, and End Results-Medicare database. We compared breast cancer stage at diagnosis and treatment among women with disabilities enrolled in Medicare managed care versus fee-for-service (FFS) Medicare.

Geographic variation in device use for intertrochanteric hip fractures.

Background: Hip fractures in the elderly are a common and costly problem, with intertrochanteric fractures accounting for almost half of these fractures. Most intertrochanteric fractures are treated with either a plate-and-screw device or an intramedullary nail device. We assessed the degree of geographic variation in use of intramedullary nailing for intertrochanteric femoral fractures among Medicare beneficiaries between 2000 and 2002.

Medicare-certified home health care: urban-rural differences in utilization.

Context: Availability of Medicare-certified home health care (HHC) to rural elders can prevent more expensive institutional care. To date, utilization of HHC by rural elders has not been studied in detail.

Purpose: To examine urban-rural differences in Medicare HHC utilization.

Postoperative irradiation for rectal cancer increases the risk of small bowel obstruction after surgery.

Objective: To determine the risk of small bowel obstruction (SBO) after irradiation (RT) for rectal cancer

Background: : SBO is a frequent complication after standard resection of rectal cancer. Although the use of RT is increasing, the effect of RT on risk of SBO is unknown.

Methods: We conducted a retrospective cohort study using Surveillance, Epidemiology, and End Results cancer registry data linked to Medicare claims data to determine the effect of RT on risk of SBO.

Trends in the incidence of invasive and in situ vulvar carcinoma.

Objective: To characterize the incidence of vulvar carcinoma in situ and vulvar cancer over time.

Methods: We used the Surveillance Epidemiology and End Results database to assess trends in the incidence of vulvar cancer over a 28-year period (1973 through 2000) and determined whether there had been a change in incidence over time. Information collected included patient characteristics, primary tumor site, tumor grade, and follow-up for vital status.

Risk of pelvic fractures in older women following pelvic irradiation.

Context: Pelvic fractures, including hip fractures, are a major source of morbidity and mortality in older women. Although therapeutic pelvic irradiation could increase the risk of such fractures, this effect has not been studied.

Objective: To determine if women who undergo pelvic irradiation for pelvic malignancies (anal, cervical, or rectal cancers) have a higher rate of pelvic fracture than women with pelvic malignancies who do not undergo irradiation.

Providing hospice care in rural areas: challenges and strategies.

Hospices in rural settings face challenges in the provision of hospice care as a result of their location and the size of their service area population. To ascertain the challenges that hospices face in serving rural communities, researchers conducted in-depth case studies of four different models of hospice care in rural areas. The authors describe strategies used by the case study hospices and recommend policies that could increase access to hospice care for rural Medicare beneficiaries and other rural residents.

Increased risk of rectal cancer after prostate radiation: a population-based study.

Background & Aims: Radiation therapy for prostate cancer has been associated with an increased rate of pelvic malignancies, particularly bladder cancer. The association between radiation therapy and colorectal cancer has not been established.

Methods: We conducted a retrospective cohort study using Surveillance, Epidemiology, and End Results (SEER) registry data from 1973 through 1994.

Do rural elders have limited access to Medicare hospice services?

Objectives: To examine whether there are urban-rural differences in use of the Medicare hospice benefit before death and whether those differences suggest that there is a problem with access to hospice care for rural Medicare beneficiaries.

Design: Observational study using 100% of Medicare enrollment, hospice, and hospital claims data.

Setting: Inpatient hospitals and hospices.

Trends in the treatment of ductal carcinoma in situ of the breast.

Background: An increase in incidence of ductal carcinoma in situ (DCIS) of the breast has been documented, and concerns regarding overly aggressive treatment have been raised. This study was designed to evaluate the use of surgery and radiation therapy in treating DCIS.

Methods: We used the National Cancer Institute's Surveillance, Epidemiology, and End Results database to assess treatment of patients with DCIS with no evidence of microinvasion who were diagnosed from January 1, 1992, through December 31, 1999.

Further experience with gastric stimulation to treat drug refractory gastroparesis.

Background: Gastric electrical stimulation (GES) has been introduced for patients with gastroparesis refractory to pharmacological therapy.

Methods: From April 1998 until November 2001, 55 patients underwent GES implantation at Kansas University Medical Center. All patients had prolonged gastric retention of a solid meal by scintigraphy at baseline.