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Mental health status, and the use of mental health services and psychotherapeutic medicines among U.S. cancer survivors and their spouses A Dissertation in Health Policy and Administration  And Demography by Rajeshwari S. Punekar
Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Background ,[object Object],[object Object],[object Object],[object Object],§ Oncology Population refers to U.S. cancer survivors and their spouses
Objectives ,[object Object],[object Object],[object Object]
Contributions ,[object Object],[object Object],[object Object]
Conceptual Framework General Health ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Mental Health Status ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Use of Mental Health Services and Psychotherapeutic Medicines
Mental Health Status ,[object Object],[object Object],[object Object],[object Object]
Mental Health Services Utilization ,[object Object],[object Object]
Psychotherapeutic Medicines Utilization ,[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Expenditure Panel Survey- Household Component (MEPS-HC) ,[object Object],[object Object],[object Object],[object Object]
National Health Interview Survey (NHIS) ,[object Object],[object Object],[object Object],[object Object]
Data 1999-2005 NHIS Cancer cases- 1,957  Spouses- 826 2001-2006 MEPS-HC Cancer cases- 679  Spouses- 300 2001-2006 NHIS-MEPS link files
Measures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Descriptive Analysis Individuals a Cancer and non-cancer individuals, below ages of 65 years, are significantly different at p=0.05 level b Cancer and non-cancer individuals, 65 and older, are significantly different at p=0.05 level 12 15 10 17 Psychotherapeutic Medicines Use  a,b 10 10 11 16 Mental Health Services Use  a 7 9 5 10 Depression  a % % % % 5 4 4 6 Non-Specific Psychological Distress (K6) Scores  a 52 52 51 49 Mental Component Scores of SF-12  a Non-cancer Cancer Non-cancer Cancer 65 and older 25-64 Outcomes
Descriptive Analysis Spouses a Cancer and non-cancer individuals, below ages of 65 years, are significantly different at p=0.05 level b Cancer and non-cancer individuals, 65 and older, are significantly different at p=0.05 level 18 23 16 27 Psychotherapeutic Medicines Use  a,b 7 10 9 12 Mental Health Services Use 6 10 4 7 Depression  a,b % % % % 3 3 3 4 Non-Specific Psychological Distress (K6) Scores  a 53 53 52 50 Mental Component Scores of SF-12  a Non-cancer Cancer Non-cancer Cancer 65 and older 25-64 Outcomes
Multivariate Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Regression coefficients and Odds Ratios (OR) for the outcome of interests in full sample * Significant at p=0.05 level  1.31* 1.34* 1.23* 1.33* Psychotherapeutic medicines utilization (OR) 1.27 1.01 1.04 1.16 Mental health services utilization (OR) 1.88* 1.77* 1.42* 1.59* Depression (OR) 0.09 0.23* 0.15* 0.23* Psychological distress -0.31 -1.12* -0.42 -1.15* MCS-12  65 and older 25-64 65 and older 25-64 Spouses Individuals Outcomes
Regression coefficients for the outcomes of interests in the oncology sample ,[object Object],[object Object],0.41 -0.52 0.24 -0.25 Prostate cancer 0.51 -1.29 0.46 -0.48 Lung cancer 0.56 0.32 0.37 0.45* Gynecological cancer -0.68 -0.69 -0.58* -0.16 Colorectal cancer Psychological Distress -1.66 1.07 -1.28 1.51 Prostate cancer 0.26 2.96 0.03 0.92 Lung cancer -3.01 -1.10 -2.25 -2.33* Gynecological cancer -0.12 -0.15 0.22 -0.41 Colorectal cancer MCS-12 65 and older 25-64 65 and older 25-64 Spouses Individuals
Odds Ratios (OR) for the outcomes of interests in the oncology sample * Significant at p=0.05 level
Summary ,[object Object],[object Object],[object Object],[object Object]
Policy Implications ,[object Object],[object Object],[object Object]
Limitations ,[object Object],[object Object],[object Object]

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Thesis Defense [06102010]

  • 1. Mental health status, and the use of mental health services and psychotherapeutic medicines among U.S. cancer survivors and their spouses A Dissertation in Health Policy and Administration And Demography by Rajeshwari S. Punekar
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
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  • 11.
  • 12. Data 1999-2005 NHIS Cancer cases- 1,957 Spouses- 826 2001-2006 MEPS-HC Cancer cases- 679 Spouses- 300 2001-2006 NHIS-MEPS link files
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  • 14.
  • 15. Descriptive Analysis Individuals a Cancer and non-cancer individuals, below ages of 65 years, are significantly different at p=0.05 level b Cancer and non-cancer individuals, 65 and older, are significantly different at p=0.05 level 12 15 10 17 Psychotherapeutic Medicines Use a,b 10 10 11 16 Mental Health Services Use a 7 9 5 10 Depression a % % % % 5 4 4 6 Non-Specific Psychological Distress (K6) Scores a 52 52 51 49 Mental Component Scores of SF-12 a Non-cancer Cancer Non-cancer Cancer 65 and older 25-64 Outcomes
  • 16. Descriptive Analysis Spouses a Cancer and non-cancer individuals, below ages of 65 years, are significantly different at p=0.05 level b Cancer and non-cancer individuals, 65 and older, are significantly different at p=0.05 level 18 23 16 27 Psychotherapeutic Medicines Use a,b 7 10 9 12 Mental Health Services Use 6 10 4 7 Depression a,b % % % % 3 3 3 4 Non-Specific Psychological Distress (K6) Scores a 53 53 52 50 Mental Component Scores of SF-12 a Non-cancer Cancer Non-cancer Cancer 65 and older 25-64 Outcomes
  • 17.
  • 18. Regression coefficients and Odds Ratios (OR) for the outcome of interests in full sample * Significant at p=0.05 level 1.31* 1.34* 1.23* 1.33* Psychotherapeutic medicines utilization (OR) 1.27 1.01 1.04 1.16 Mental health services utilization (OR) 1.88* 1.77* 1.42* 1.59* Depression (OR) 0.09 0.23* 0.15* 0.23* Psychological distress -0.31 -1.12* -0.42 -1.15* MCS-12 65 and older 25-64 65 and older 25-64 Spouses Individuals Outcomes
  • 19.
  • 20. Odds Ratios (OR) for the outcomes of interests in the oncology sample * Significant at p=0.05 level
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  • 23.