“Age matters”—German claims data indicate disparities in lung cancer care between elderly and young patients

• DOI: 10.1371/journal.pone.0217434
• Publication Date: 2019-06-12T17:30:16Z
• Authors: Julia Walter; Amanda Tufman; Rolf Holle; Larissa Schwarzkopf
• Keywords: Aged, 80 and over; Male; Rural Population; Lung Neoplasms; Science; Q; Palliative Care; R; Comorbidity; 3. Good health; 03 medical and health sciences; Logistic Models; 0302 clinical medicine; Medicine; Humans; Female; Research Article; Aged; Retrospective Studies

Background Although lung cancer is most commonly diagnosed in elderly patients, evidence about tumor-directed therapy patients sparse, and it unclear to what extent this affects treatment care. Our study aimed discover potential disparities care between those under 65 years of age. Methods We studied claims from 13 283 German with 2009 who survived for at least 90 days after diagnosis. classified as "non-elderly" (≤ 65), "young-old" (65–74), "middle-old" (75–84), "old-old" (≥ 85). compared receipt (6 months diagnosis), palliative care, opioids, antidepressants, pathologic diagnosis confirmation via logistic regression. used generalized linear regression (gamma distribution) compare group-specific costs 3 adjusted all models by age, nursing home residency, need, comorbidity burden, area residence (urban, rural). The age group served reference group. Results Compared the "non-elderly", likelihood receiving any was significantly lower groups a decreasing gradient advancing Elderly received fewer resections radiotherapy than non-elderly patients. In particular, antineoplastic declined increasing ("young-old" (OR = 0.76, CI [0.70,0.83]), 0.45, [0.36,0.50]), 0.13, [0.10,0.17])). Patients were less likely receive structured 0.84, [0.76,0.92]), 0.71, [0.63,0.79]), 0.57, [0.44,0.73])). Moreover, increased associated reduced quotas outpatient opioids antidepressants. Costs decreased Conclusion This suggests existence age-dependent where are risk undertreatment. To support equal access adjustments public health policies seem be urgently required.