{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T21:31:41Z","timestamp":1768080701826,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,5,22]],"date-time":"2015-05-22T00:00:00Z","timestamp":1432252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To examine associations between quality of care, short\u2010 and long\u2010term treatment\u2010related outcomes, and costs in elderly patients treated for laryngeal squamous cell cancer (SCCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis of Surveillance, Epidemiology, and End Results\u2010Medicare data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated longitudinal data from 2,370 patients diagnosed with laryngeal SCCA from 2004 to 2007 using cross\u2010tabulations, multivariate regression, and survival analysis. Using quality indicators derived from guidelines for recommended care and performance measures, an overall summary measure of quality was calculated incorporating summary quality measures for diagnosis, initial treatment, performance, surveillance, treatment for recurrence, and end\u2010of\u2010life care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher\u2010quality care was associated with a lower likelihood of long\u2010term weight loss (odds ratio [OR]\u2009=\u20090.6 [0.5\u20130.8]), stricture (OR\u2009=\u20090.5 [0.3\u20130.8]), gastrostomy dependence (OR\u2009=\u20090.5 [0.4\u20130.7]), airway obstruction (OR\u2009=\u20090.7 [0.6\u20130.9]), tracheostomy (OR\u2009=\u20090.5 [0.3\u20130.7]), and pneumonia (OR\u2009=\u20090.7 [0.5\u20130.9]), but had no impact on the likelihood of dysphagia. Higher\u2010quality care was associated with lower risk of death in patients with dysphagia (hazard ratio [HR]\u2009=\u20090.7 [0.6\u20130.8]), weight loss (HR\u2009=\u20090.8 [0.6\u20130.9]), airway obstruction (HR\u2009=\u20090.7 [0.6\u20130.8]), tracheostomy (HR\u2009=\u20090.7 [0.5\u20130.9]), and pneumonia (HR\u2009=\u20090.8 [0.6\u20130.9]), but was not associated with survival differences in patients with gastrostomy dependence or stricture. Costs associated with dysphagia, weight loss, stricture, airway obstruction, and pneumonia were lower for patients receiving higher\u2010quality care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Higher\u2010quality larynx cancer care was associated with a reduced incidence of late airway and swallowing impairment after laryngeal SCCA treatment in elderly patients, with improved survival and reduced costs. These data suggest that greater attention to evidence\u2010based practices associated with quality indicators may lead to improved functional outcomes in the elderly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c. <jats:italic>Laryngoscope<\/jats:italic>, 125:2323\u20132329, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25378","type":"journal-article","created":{"date-parts":[[2015,5,22]],"date-time":"2015-05-22T12:57:22Z","timestamp":1432299442000},"page":"2323-2329","source":"Crossref","is-referenced-by-count":27,"title":["Quality of care and short\u2010 and long\u2010term outcomes of laryngeal cancer care in the elderly"],"prefix":"10.1002","volume":"125","author":[{"given":"Christine G.","family":"Gourin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather M.","family":"Starmer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Herbert","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management the Johns Hopkins Bloomberg School of Public Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin D.","family":"Frick","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management the Johns Hopkins Bloomberg School of Public Health"},{"name":"Johns Hopkins Carey Business School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arlene A.","family":"Forastiere","sequence":"additional","affiliation":[{"name":"Department of Oncology Sidney Kimmel Comprehensive Cancer Center Baltimore Maryland U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Quon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Eisele","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sydney M.","family":"Dy","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management the Johns Hopkins Bloomberg School of Public Health"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,5,22]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Ensuring Quality Cancer Care","author":"National Cancer Policy Board, Institute of Medicine and National Research Council","year":"1999"},{"key":"e_1_2_6_3_1","volume-title":"Delivering High\u2010Quality Cancer Care","author":"Institute of Medicine","year":"2013"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24593"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25012"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90133-8"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(00)00256-0"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24574"},{"key":"e_1_2_6_10_1","unstructured":"U.S. Department of Labor; Bureau of Labor Statistics Consumer Price Index Inflation Calculator. 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