title: Health care utilization by adult long-term survivors of hematopoietic cell transplant: report from the Bone Marrow Transplant Survivor Study.
abstract: The high intensity of therapy and prolonged immune suppression after hematopoietic cell transplantation (HCT) increase the risk of long-term complications and health care needs among survivors. The aim of this study was to evaluate the current status of health care utilization by long-term HCT survivors and to identify factors associated with lack of utilization. A total of 845 individuals who had undergone HCT between 1974 and 1998 at age 21 years or older and survived 2 or more years after HCT participated in the study. Health care utilization was assessed through a mailed questionnaire in three domains: general contact with health care system, general physical examination, and cancer/HCT-related visit. The median age at HCT was 38.2 years, and the median length of follow-up was 6.4 years. Overall, 98% of allogeneic and 94% of autologous HCT survivors reported medical contact 11+ years after HCT. Cancer/HCT-related visits decreased with increasing time from HCT (allogeneic HCT, 98-57%; autologous HCT, 94-63%). The prevalence of general physical examination increased with time (allogeneic HCT, 56-74%; autologous HCT, 72-81%). Primary care physicians provide health care for an increasing number of adult long-term survivors of HCT, emphasizing the need for increased awareness of the long-term follow-up needs of the HCT survivors by the health care providers.
authors.affiliation: Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA.
authors.forename: Sadhna M
authors.initials: SM
authors.lastname: Shankar
authors.forename: Andrea
authors.initials: A
authors.lastname: Carter
authors.forename: Can-Lan
authors.initials: CL
authors.lastname: Sun
authors.forename: Liton
authors.initials: L
authors.lastname: Francisco
authors.forename: K Scott
authors.initials: KS
authors.lastname: Baker
authors.forename: James G
authors.initials: JG
authors.lastname: Gurney
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Weisdorf
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Forman
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Smita
authors.initials: S
authors.lastname: Bhatia
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors