Health care utilization by adult long-term survivors of hematopoietic cell transplant: report from the Bone Marrow Transplant Survivor Study.
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.
Shankar
Sadhna M
SM
Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA.
Carter
Andrea
A
Sun
Can-Lan
CL
Francisco
Liton
L
Baker
K Scott
KS
Gurney
James G
JG
Weisdorf
Daniel G
DG
Forman
Stephen J
SJ
Robison
Leslie L
LL
Grant
Marcia
M
Bhatia
Smita
S
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