Determinants of mortality following a diagnosis of prostate cancer in Veterans Affairs and private sector health care systems.
OBJECTIVE
We compared patterns of mortality among men with prostate cancer at 2 Department of Veterans Affairs (VA) and 2 private-sector hospitals in the Chicago area.


METHODS
Mortality rates for 864 cases diagnosed between 1986 and 1990 were estimated using Cox proportional hazards models that incorporated age; income; cancer stage, differentiation, and treatments; and baseline comorbidity.


RESULTS
Race tended to associate with all-cause mortality irrespective of health care setting (Blacks vs Whites: hazard rate ratio [HRR] = 1.68 [95% confidence interval (CI) = 1.06, 2.67]; P <.001 in the private sector; HRR = 1.50 [95% CI = 0.94, 2.38]; P =.088 in the VA). However, comorbidity determined risk in the VA, whereas age and income predicted risk in the private sector.


CONCLUSIONS
Determinants of all-cause mortality in men with prostate cancer vary according to health care setting.
Freeman
Vincent L
VL
VA Hospital, Hines, IL 60141, USA. freem595@aol.com
Durazo-Arvizu
Ramon
R
Arozullah
Ahsan M
AM
Keys
LaShon C
LC
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002641:Chicago / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D015438:Health Behavior / Q000208:ethnology; D006297:Health Services Accessibility; D017052:Hospital Mortality; D016304:Hospitals, Private / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000401:mortality*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016019:Survival Analysis; D044465:White People / Q000706:statistics & numerical data*