Biomedical subjects

Kathleen Oberst

Publications and source records attributed to Kathleen Oberst.

5 recordsLinked to original sources

PubMed2006

Absenteeism from work: the experience of employed breast and prostate cancer patients in the months following diagnosis.

BACKGROUND: A better understanding of how cancer treatments affect patient's employment may help patients and physicians make more informed choices between treatment alternatives. This study examined the number of days employed patients undergoing treatment for either breast or prostate cancer were absent from their jobs. METHOD: Using the Detroit Surveillance, Epidemiology, End-Results registry, all potentially eligible women diagnosed with breast cancer and men diagnosed with prostate cancer were selected. Subjects who were employed full-time were included in this analysis. RESULTS: Women treated for breast cancer missed an average of 44.5 days from work; the median days missed was 22. The median days missed by women treated with surgery and chemotherapy was 40. Men diagnosed with prostate cancer missed an average of 27 days (median days = 20) from work. The median days missed for men treated surgically without hormone or radiation therapy was 25. In multivariable analyses, taking a leave of absence and greater elapsed time from diagnosis to interview were associated with the greatest number of days absent from work for all patients. Men treated with hormone and/or radiation therapy or who were not treated missed fewer days from work relative to men undergoing surgery. CONCLUSION: Research and interventions are needed to minimize work loss for cancer patients. Vocational rehabilitation programs may minimize the impact of treatment on work. Information on how treatments may infringe the ability for patients to earn a living may influence treatment decisions.

Absenteeism↗

PubMed2005

Increasing generic prescribing: a resident educational intervention.

BACKGROUND AND OBJECTIVES: Future physicians are urged to balance effectiveness and cost in their prescribing of medications. This study determined whether educational sessions for residents together with a "Resident Report Card" changed residents' prescribing of generic medications in both commercial and Medicaid patient panels, compared with regional performance of physicians in practice in the community. METHODS: Twenty-four family medicine residents providing care for 1,038 (600 Medicaid and 438 commercial) members (or 31,140 total member months) received biannual profiles of their prescribing patterns and participated in four training sessions related to prescription profiling within a regional health plan. We monitored prescribing during two time periods and compared rates of generic prescribing to a baseline rate. RESULTS: Resident generic prescribing increased significantly for commercial members, from a base period (July 1, 2000-June 30, 2001) rate of 38.4% to a period 1 (July 1, 2001-June 30, 2002) rate of 38.0% and a period 2 (July 1, 2002-December 31, 2002) rate of 47.9%. It also increased for Medicaid members, from a base period rate of 47.8% to a period 1 rate of 49.1% and a period 2 rate of 52.6%. There was no similar change in regional prescribing performance during the same periods for physicians in practice in the community. CONCLUSIONS: Feedback systems and training based on actual health plan data can be developed for residency training on prescribing performance, resulting in improved cost-efficient prescribing patterns.

Drug Costs↗

PubMedDate not supplied

Rapid assessment of the needs and health status in Santa Rosa and Escambia counties, Florida, after Hurricane Ivan, September 2004.

BACKGROUND: Hurricane Ivan, a Category 3 storm, devastated the Florida panhandle on September 16, 2004, causing extensive property damage and 24 deaths. The Florida Department of Health requested assistance from the Centers for Disease Control and Prevention to conduct a rapid assessment in Santa Rosa and Escambia counties to determine the health impact of the hurricane and needs of the affected population. METHODS: A questionnaire was administered 6 days after the hurricane made landfall. The survey instrument elicited information about house damage, illness/injury, and access to utilities. A modified cluster sampling method was used to select 30 clusters in each county. Seven households were interviewed in each cluster and reported weighted frequencies. RESULTS: Three quarters of houses in each county were damaged. Households in Santa Rosa and Escambia lacked basic utilities, including regular garbage pick-up, telephone service, and electricity. Fifty-four percent of households in Santa Rosa and 27% in Escambia reported using a generator. The most commonly self-reported health conditions were sleep disturbances in Santa Rosa (54%) and upper respiratory problems in Escambia (46%). Injuries were reported in fewer than 15% of households in each county. CONCLUSION: Rapid restoration of power, telephone services, and debris pick-up remained a priority 1 week after the event. Findings demonstrated the need for (1) mental health and primary care services, (2) information about safe generator use, and (3) ways to access medical care and medications.

Centers for Disease Control and Prevention, U.S.↗

PubMedDate not supplied

Combining registry, primary, and secondary data sources to identify the impact of cancer on labor market outcomes.

Some cancers are rapidly becoming chronic conditions that are more and more often diagnosed in working-age individuals. The authors developed a research agenda to study the labor market outcomes attributable to detection and treatment for cancer, and research design and data collection strategies to improve upon other research on these questions. In this article, they describe their approach to combining secondary data sources, primary data collection, and cancer registry data to evaluate the impact cancer has on labor market outcomes such as employment, hours worked, wages, and health insurance. They then critically assess how well their study design and data collection strategy accomplished its objectives. The intention is to offer guidance on how researchers, who are interested in the economic consequences of cancer, as well as of other chronic conditions, might develop and execute studies that examine labor market outcomes. As more attention is placed on the economic aspects of disease, the methods used to estimate productivity loss and other economic outcomes attributable to these conditions require careful scrutiny so that reliable findings can be used to shape health care decisions and policy.

Breast Neoplasms↗

PubMedDate not supplied

Impact of Hurricane Ivan on pharmacies in Baldwin County, Alabama.

OBJECTIVE: To evaluate the impact of Hurricane Ivan, which made landfall east of Mobile, Alabama, on September 16, 2004, on pharmacies in the affected areas. DESIGN: Retrospective cross-sectional analysis. SETTING: Baldwin County, Alabama. INTERVENTIONS: Pharmacy community rapid-needs-assessment survey. PARTICIPANTS: 41 hospital and community (chain and independent) pharmacies. MAIN OUTCOME MEASURES: Posthurricane pharmacy hours of operations, prescription volumes, infrastructure damage, and prehurricane disaster planning. RESULTS: During the week of the hurricane, both chain and independent community pharmacies within the evacuation zone worked significantly fewer hours (46% and 49%, respectively) and dispensed significantly fewer prescriptions (37% and 52%) compared with the same week of the prior year. Overall, 40% of pharmacies depleted their supplies of certain medications (e.g., anxiolytics, antihypertensives). A total of 60% of the chain and independent pharmacies outside the evacuation zone closed because of loss of electricity, but pharmacies with a generator were significantly less likely to report having turned away patients. The proportion of pharmacies that had a disaster plan but turned away patients or rationed or ran out of medications was similar to that of pharmacies without a disaster plan. CONCLUSION: Although Hurricane Ivan primarily affected the operation of pharmacies within the evacuation zone, pharmacies in the surrounding area were also affected because of loss of power. Emergency management officials should evaluate the efficacy of specific guidelines outlined in disaster plans and identify ways to deliver essential medications to people in disaster-affected areas.

Alabama↗