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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Hongdao Meng, MPH1, Bruce Friedman, PhD1, Brenda Wamsley, MSW2, and David Oakes, PhD3. (1) Department of Community and Preventive Medicine, University of Rochester, Box 644, Rochester, NY 14642, 585-248-8770, hongdao_meng@urmc.rochester.edu, (2) Executive Director, Center for Aging & Healthcare in West Virginia, 517 Market Street, Dils Building, Parkersburg, WV 26101, (3) Biostatistics, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642
As part of a Medicare demonstration, "A Randomized Controlled Trial of Primary and Consumer-Directed Care for People with Chronic Illness" (CMS No. 95-C-90467/2-01), we tested the null hypothesis that intervention will not affect mortality and the probability of survival. 1609 participants sequentially entered the study between July 26, 1998 and June 25, 2000. They were randomly assigned into one of four groups: health promotion nurse, voucher for in-home supportive services and equipment, combination of nurse and voucher, and control. All patients will have been followed for two years by June 24, 2002.
We compared the crude mortality rate across the groups and by sites. We also performed a non-parametric log-rank test as well as semi-parametric Cox Proportional Hazard modeling on the first year survival (length of survival measured in weeks).
Our preliminary analysis shows no difference in the first year mortality rate across all groups. The log-rank test supports the same result. The Cox Proportional model indicates that age and gender are statistically significant predictors of survival, but intervention group and site (New York site vs. West Virginia/Ohio site) are not. We plan to control for the following factors in the full analysis: demographic variables, insurance status, functional status, co-morbidities, depressive symptoms, and cognitive functioning.
Learning Objectives: Learning Objectives
Keywords: Medicare/Medicaid, Mortality
Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment