Association Between the Availability of Medical Oncologists and Initiation of Chemotherapy for Patients With Stage III Colon Cancer

Lin, Chun Chieh; Virgo, Katherine S.

doi:10.1200/jop.2012.000627

Cited by 11 publications

(7 citation statements)

References 25 publications

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“…However, once other variables were adjusted for, women residing in Appalachia were less likely to receive guideline‐recommended cancer treatment. Unmeasured factors such as travel time to cancer treatment facilities, availability of oncologists, and treating oncologists' knowledge of guideline‐based care could partially account for these findings 43–47 . Appalachian and non‐Appalachian patients' demographic and clinical characteristics differed.…”

Section: Discussionmentioning

confidence: 99%

“…Unmeasured factors such as travel time to cancer treatment facilities, availability of oncologists, and treating oncologists' knowledge of guideline-based care could partially account for these findings. [43][44][45][46][47] Appalachian and non-Appalachian patients' demographic and clinical characteristics differed. Disparities in age group, percentage of high school or higher education, primary insurance payer, and based on inpatient and outpatient visits recorded in administrative data, not a structured clinical diagnostic interview.…”

Section: Discussionmentioning

confidence: 99%

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Influence of depression on breast cancer treatment and survival: A Kentucky population‐based study

Lei

Vanderpool

McLouth

et al. 2023

Cancer

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Background Depression is common among breast cancer patients and can affect concordance with guideline‐recommended treatment plans. Yet, the impact of depression on cancer treatment and survival is understudied, particularly in relation to the timing of the depression diagnosis. Methods The Kentucky Cancer Registry data was used to identify female patients diagnosed with primary invasive breast cancer who were 20 years of age or older in 2007–2011. Patients were classified as having no depression, depression pre‐cancer diagnosis only, depression post‐ cancer diagnosis only, or persistent depression. The impact of depression on receiving guideline‐recommended treatment and survival was examined using multivariable logistic regression and Cox regression, respectively. Results Of 6054 eligible patients, 4.1%, 3.7%, and 6.2% patients had persistent depression, depression pre‐diagnosis only, and depression post‐diagnosis only, respectively. A total of 1770 (29.2%) patients did not receive guideline‐recommended cancer treatment. Compared to patients with no depression, the odds of receiving guideline‐recommended treatment were decreased in patients with depression pre‐diagnosis only (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.54–1.04) but not in patients with post‐diagnosis only or persistent depression. Depression post‐diagnosis only (hazard ratio, 1.51; 95% CI, 1.24–1.83) and depression pre‐diagnosis only (hazard ratio, 1.26; 95% CI, 0.99–1.59) were associated with worse survival. No significant difference in survival was found between patients with persistent depression and patients with no depression (p > .05). Conclusions Neglecting depression management after a breast cancer diagnosis may result in poorer cancer treatment concordance and worse survival. Early detection and consistent management of depression is critical in improving patient survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of depression on breast cancer treatment and survival: A Kentucky population‐based study

Lei

Vanderpool

McLouth

et al. 2023

Cancer

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“…Turning to physical health, racial disparities are also found in the treatment of cardiac disease and many different cancers, including breast, lung, prostate, colorectal and other gastrointestinal cancers (e.g., Berger, Lund, & Brawley, 2007; Griggs, Sorbero, Stark, Heininger, & Dick, 2003; Lin & Virgo, 2013; Morris et al 2008; Shavers et al, 2004; Underwood et al, 2004). One might expect that in situations in which swift and decisive action is required racial healthcare disparities might disappear, but treatment disparities also exist in emergency room settings.…”

Section: Social Psychological Theory and Racial Healthcare Disparitiesmentioning

confidence: 99%

Racial healthcare disparities: A social psychological analysis

Penner

Hagiwara

Eggly

et al. 2013

European Review of Social Psychology

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Around the world, members of racial/ethnic minority groups typically experience poorer health than members of racial/ethnic majority groups. The core premise of this article is that thoughts, feelings, and behaviors related to race and ethnicity play a critical role in healthcare disparities. Social psychological theories of the origins and consequences of these thoughts, feelings, and behaviors offer critical insights into the processes responsible for these disparities and suggest interventions to address them. We present a multilevel model that explains how societal, intrapersonal, and interpersonal factors can influence ethnic/racial health disparities. We focus our literature review, including our own research, and conceptual analysis at the intrapersonal (the race-related thoughts and feelings of minority patients and non-minority physicians) and interpersonal levels (intergroup processes that affect medical interactions between minority patients and non-minority physicians). At both levels of analysis, we use theories of social categorization, social identity, contemporary forms of racial bias, stereotype activation, stigma, and other social psychological processes to identify and understand potential causes and processes of health and healthcare disparities. In the final section, we identify theory-based interventions that might reduce ethnic/racial disparities in health and healthcare.

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“…Patients who live in areas where chemotherapy providers are scarce must travel extended distances to receive treatment [ 1 – 3 ]. Research suggests that some patients who may benefit from chemotherapy remain untreated because of where they live [ 1 , 2 , 4 – 6 ]. Thus measures of geographic access to chemotherapy have been constructed to better understand these potential barriers to treatment.…”

Section: Introductionmentioning

confidence: 99%

“…One paper used billing codes [ 17 ] and another used both billing and specialty codes [ 5 ]. Another strategy has been to supplement Medicare data with outside sources, such as the American Medical Association (AMA) physician masterfile or the Area Health Resource Files [ 1 , 2 , 4 , 18 – 20 ]. Although doing so has been shown to capture more oncologists [ 12 , 13 ], our objective was slightly different.…”

Section: Introductionmentioning

confidence: 99%

Variation in geographic access to chemotherapy by definitions of providers and service locations: a population-based observational study

Schroeder

Chapman

Nattinger

et al. 2016

BMC Health Serv Res

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BackgroundAn aging population, with its associated rise in cancer incidence and strain on the oncology workforce, will continue to motivate patients, healthcare providers and policy makers to better understand the existing and growing challenges of access to chemotherapy. Administrative data, and SEER-Medicare data in particular, have been used to assess patterns of healthcare utilization because of its rich information regarding patients, their treatments, and their providers. To create measures of geographic access to chemotherapy, patients and oncologists must first be identified. Others have noted that identifying chemotherapy providers from Medicare claims is not always straightforward, as providers may report multiple or incorrect specialties and/or practice in multiple locations. Although previous studies have found that specialty codes alone fail to identify all oncologists, none have assessed whether various methods of identifying chemotherapy providers and their locations affect estimates of geographic access to care.MethodsSEER-Medicare data was used to identify patients, physicians, and chemotherapy use in this population-based observational study. We compared two measures of geographic access to chemotherapy, local area density and distance to nearest provider, across two definitions of chemotherapy provider (identified by specialty codes or billing codes) and two definitions of chemotherapy service location (where chemotherapy services were proven to be or possibly available) using descriptive statistics. Access measures were mapped for three representative registries.ResultsIn our sample, 57.2 % of physicians who submitted chemotherapy claims reported a specialty of hematology/oncology or medical oncology. These physicians were associated with 91.0 % of the chemotherapy claims. When providers were identified through billing codes instead of specialty codes, an additional 50.0 % of beneficiaries (from 23.8 % to 35.7 %) resided in the same ZIP code as a chemotherapy provider. Beneficiaries were also 1.3 times closer to a provider, in terms of driving time. Our access measures did not differ significantly across definitions of service location.ConclusionsMeasures of geographic access to care were sensitive to definitions of chemotherapy providers; far more providers were identified through billing codes than specialty codes. They were not sensitive to definitions of service locations, as providers, regardless of how they are identified, generally provided chemotherapy at each of their practice locations.

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Association Between the Availability of Medical Oncologists and Initiation of Chemotherapy for Patients With Stage III Colon Cancer

Cited by 11 publications

References 25 publications

Influence of depression on breast cancer treatment and survival: A Kentucky population‐based study

Influence of depression on breast cancer treatment and survival: A Kentucky population‐based study

Racial healthcare disparities: A social psychological analysis

Variation in geographic access to chemotherapy by definitions of providers and service locations: a population-based observational study

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