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Conceptualization and sources of costs from breast cancer: findings from patient and caregiver focus groups.

https://arctichealth.org/en/permalink/ahliterature178255
Source
Psychooncology. 2005 May;14(5):351-60
Publication Type
Article
Date
May-2005
Author
Sophie Lauzier
Elizabeth Maunsell
Maria De Koninck
Mélanie Drolet
Nicole Hébert-Croteau
Jean Robert
Author Affiliation
Population Health Research Unit, Department of Social and Preventive Medicine, Université Laval, Québec, Canada.
Source
Psychooncology. 2005 May;14(5):351-60
Date
May-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - complications - psychology - therapy
Canada
Caregivers
Cost of Illness
Costs and Cost Analysis
Female
Focus Groups
Health Care Costs - statistics & numerical data
Humans
Middle Aged
Abstract
Assessment of economic burden of breast cancer to patient and family has generally been overlooked in assessing the impact of this disease. We explored economic aspects from the perspective of women and their caregivers. Focus groups were conducted in 3 Quebec cities representing urban and semi-urban settings: 3 with 26 women first treated for non-metastatic breast cancer in the past 18 months, and 3 with 24 primary caregivers. We purposefully selected participants with different characteristics likely to affect the nature or extent of costs. Thematic content analysis was conducted on verbatim transcripts. Costs of breast cancer could be substantial, but were not the most worrisome aspect of the illness during treatments. Some costs were considered unavoidable, others depended on ability to pay. Costs occurred over a long period, with long term impact, and were borne by the whole family and not just the woman. Principal cost sources discussed were those associated with accessing health care, wage losses, reorganization of everyday life, and coping with the disease. This study provided deeper understanding of cost dynamics and the experience of costs among Canadian women with non-metastatic breast cancer, whose treatment and medical follow-up costs are borne through a system of universal, publicly funded health care.
PubMed ID
15386763 View in PubMed
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Investigating the correlation between hospital of primary treatment and the survival of women with breast cancer.

https://arctichealth.org/en/permalink/ahliterature173443
Source
Cancer. 2005 Oct 1;104(7):1343-8
Publication Type
Article
Date
Oct-1-2005
Author
Nicole Hébert-Croteau
Jacques Brisson
Jacques Lemaire
Jean Latreille
Raynald Pineault
Author Affiliation
Direction des Systèmes de Soins et Services, Institut National de Santé Publique du Québec, Montréal, Québec, Canada. nicole.hebert-croteau@inspq.qc.ca
Source
Cancer. 2005 Oct 1;104(7):1343-8
Date
Oct-1-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - mortality - pathology - therapy
Chemotherapy, Adjuvant - utilization
Cohort Studies
Combined Modality Therapy
Confidence Intervals
Female
Health Care Surveys
Hospitals - classification
Humans
Mastectomy - methods - utilization
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Outcome Assessment (Health Care)
Primary Health Care - standards - trends
Proportional Hazards Models
Quebec - epidemiology
Radiotherapy, Adjuvant - utilization
Retrospective Studies
Risk assessment
Survival Analysis
Total Quality Management
Treatment Outcome
Abstract
To understand the relation between hospital of initial treatment and the survival of women with breast cancer, the authors investigated the characteristics of the treatment center that were related most to outcome.
The authors selected women from 5 regions of Quebec, Canada, who were diagnosed with lymph node-negative breast cancer between 1988 and 1994. Data were collected by chart review, queries to physicians, and linkage with administrative data bases. Overall survival to the end of 1999 was analyzed using the Kaplan-Meier method and Cox proportional hazards models.
The study population included 1727 women with a median follow-up of 6.8 years. The 7-year survival rate was 82% (95% confidence interval [95%CI], 80-84%). Compared with women who were treated in centers with > or = 100 new cases per year, the hazard ratio (HR) of death from any cause was 1.80 (95%CI, 1.23-2.63), 1.44 (95%CI, 1.03-2.03), and 1.30 (95%CI, 0.96-1.76) among women who were treated in hospitals with
PubMed ID
16080144 View in PubMed
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Quantitative exploration of possible reasons for the recent improvement in breast cancer survival.

https://arctichealth.org/en/permalink/ahliterature165374
Source
Breast Cancer Res Treat. 2007 Dec;106(3):419-31
Publication Type
Article
Date
Dec-2007
Author
Sylvie Bérubé
Louise Provencher
Jean Robert
Simon Jacob
Nicole Hébert-Croteau
Julie Lemieux
Thierry Duchesne
Jacques Brisson
Author Affiliation
Unité de recherche en santé des populations, Hôpital St-Sacrement du Centre hospitalier affilié universitaire de Québec, 1050 Chemin Sainte-Foy, Québec, Qc, Canada, G1S 4L8.
Source
Breast Cancer Res Treat. 2007 Dec;106(3):419-31
Date
Dec-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - mortality - pathology - therapy
Canada - epidemiology
Female
Humans
Middle Aged
Time Factors
Abstract
Breast cancer mortality has been declining in many countries including Canada because of improvements in survival. This study attempts to explain observed trends in breast cancer survival with special attention given to the role of improvements in early detection and treatment.
This study is based on 4,312 women diagnosed with primary invasive breast carcinoma treated in a Canadian breast center between 1976 and 2000 and followed to the end of 2001. Observed and relative survival rates were calculated. Multivariate relative survival regression models were used to assess trends in breast cancer survival over the study period.
The proportion of women with small tumors (
PubMed ID
17268811 View in PubMed
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Validity of information obtained from a method for estimating cancer costs from the perspective of patients and caregivers.

https://arctichealth.org/en/permalink/ahliterature145927
Source
Qual Life Res. 2010 Mar;19(2):177-89
Publication Type
Article
Date
Mar-2010
Author
Sophie Lauzier
Elizabeth Maunsell
Mélanie Drolet
Douglas Coyle
Nicole Hébert-Croteau
Author Affiliation
Unité de Recherche en Santé des Populations (URESP), Centre de Recherche FRSQ du Centre Hospitalier Affilié Universitaire de Québec, 1050 Chemin Sainte-Foy, Québec, QC G1S 4L8, Canada.
Source
Qual Life Res. 2010 Mar;19(2):177-89
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Algorithms
Breast Neoplasms - economics - radiotherapy
Caregivers - economics - psychology
Deductibles and Coinsurance - economics - statistics & numerical data
Female
Focus Groups
Health Care Costs - statistics & numerical data
Humans
Information Dissemination - methods
Patient Satisfaction - statistics & numerical data
Prospective Studies
Quebec
Questionnaires - standards
Women's Health - economics
Abstract
We describe a method we developed for estimating cancer costs from the perspective of patients and caregivers and evidence supporting validity of estimates obtained.
To increase validity, interview questions were anchored to treatments; costs were divided into their components; most questions focused on facts; and the research team combined responses into cost estimates. Evidence for validity comes from a prospective study of breast cancer costs using this method.
Estimates obtained using interview responses were similar to those from independent sources. Women reported being reimbursed $205 on average for prosthesis (government reimbursement =$200); paying $15.48 per night at cancer lodge (average rate =$17.52); receiving government illness insurance for 14.6 weeks at 53% of usual salary (governmental program covers 15 weeks at 55%). A priori hypotheses about relations of costs with other characteristics were also confirmed. For example, patients' weekly travel costs increased as a function of distance from the radiotherapy center, with patients living
PubMed ID
20094806 View in PubMed
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Volume of screening mammography and performance in the Quebec population-based Breast Cancer Screening Program.

https://arctichealth.org/en/permalink/ahliterature176594
Source
CMAJ. 2005 Jan 18;172(2):195-9
Publication Type
Article
Date
Jan-18-2005
Author
Isabelle Théberge
Nicole Hébert-Croteau
André Langlois
Diane Major
Jacques Brisson
Author Affiliation
Direction des systèmes de soins et services, Institut national de santé publique du Québec, Sainte-Foy, Qué.
Source
CMAJ. 2005 Jan 18;172(2):195-9
Date
Jan-18-2005
Language
English
Publication Type
Article
Keywords
Aged
Breast Neoplasms - radiography
Clinical Competence
False Positive Reactions
Female
Humans
Mammography - standards - utilization
Middle Aged
Quality of Health Care
Quebec
Risk factors
Workload
Abstract
In the Quebec Breast Cancer Screening Program (Programme quebecois de depistage du cancer du sein [PQDCS]), radiologists' and facilities' volumes of screening mammography vary considerably. We examined the relation of screening-mammography volume to rates of breast cancer detection and false-positive readings in the PQDCS.
The study population included 307,314 asymptomatic women aged 50-69 years screened during 1998-2000. Breast cancer detection rates were analyzed by comparing all women with screening-detected breast cancer (n = 1709) and a 10% random sample of those without (n = 30,560). False-positive rates were analyzed by comparing the 3159 women with false-positive readings and the 27,401 others in the 10% random sample. Characteristics of participants, radiologists and facilities were obtained from the PQDCS information system. Data were analyzed by means of logistic regression.
The rate of breast cancer detection appeared to be unrelated to the radiologist's screening-mammography volume but increased with the facility's screening-mammography volume. The breast cancer detection rate ratio for facilities performing 4000 or more screenings per year, compared with those performing fewer than 2000, was 1.28 (95% confidence interval [CI] 1.07-1.52). In contrast, the frequency of false-positive readings was unrelated to the facility's screening volume but was inversely related to the radiologist's screening volume: the rate ratio for readers of 1500 or more screenings per year compared with those reading fewer than 250 was 0.53 (95% CI 0.35-0.79).
Radiologists' and facilities' caseloads showed independent and complementary associations with performance of screening mammography in the PQDCS. Radiologists who worked in larger facilities and read more screening mammograms had higher breast cancer detection rates while maintaining lower false-positive rates.
Notes
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Comment In: CMAJ. 2005 Jan 18;172(2):210-115655243
PubMed ID
15655240 View in PubMed
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Wage losses in the year after breast cancer: extent and determinants among Canadian women.

https://arctichealth.org/en/permalink/ahliterature158514
Source
J Natl Cancer Inst. 2008 Mar 5;100(5):321-32
Publication Type
Article
Date
Mar-5-2008
Author
Sophie Lauzier
Elizabeth Maunsell
Mélanie Drolet
Douglas Coyle
Nicole Hébert-Croteau
Jacques Brisson
Benoît Mâsse
Belkacem Abdous
André Robidoux
Jean Robert
Author Affiliation
Unité de recherche en santé des populations, Centre de recherche du Centre Hospitalier Affilié Universitaire de Québec, Québec, Canada.
Source
J Natl Cancer Inst. 2008 Mar 5;100(5):321-32
Date
Mar-5-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Breast Neoplasms - economics - pathology - therapy
Canada
Cohort Studies
Cost of Illness
Employment
Female
Humans
Linear Models
Middle Aged
Multivariate Analysis
Prospective Studies
Quebec
Questionnaires
Salaries and Fringe Benefits
Abstract
Wage losses after breast cancer may result in considerable financial burden. Their assessment is made more urgent because more women now participate in the workforce and because breast cancer is managed using multiple treatment modalities that could lead to long work absences. We evaluated wage losses, their determinants, and the associations between wage losses and changes for the worse in the family's financial situation among Canadian women over the first 12 months after diagnosis of early breast cancer.
We conducted a prospective cohort study among women with breast cancer from eight hospitals throughout the province of Quebec. Information that permitted the calculation of wage losses and information on potential determinants of wage losses were collected by three pretested telephone interviews conducted over the year following the start of treatment. Information on medical characteristics was obtained from medical records. The main outcome was the proportion of annual wages lost because of breast cancer. Multivariable analysis of variance using the general linear model was used to identify personal, medical, and employment characteristics associated with the proportion of wages lost. All statistical tests were two-sided.
Among 962 eligible breast cancer patients, 800 completed all three interviews. Of these, 459 had a paying job during the month before diagnosis. On average, these working women lost 27% of their projected usual annual wages (median = 19%) after compensation received had been taken into account. Multivariable analysis showed that a higher percentage of lost wages was statistically significantly associated with a lower level of education (P(trend) = .0018), living 50 km or more from the hospital where surgery was performed (P = .070), lower social support (P = .012), having invasive disease (P = .086), receipt of chemotherapy (P
PubMed ID
18314472 View in PubMed
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6 records – page 1 of 1.