Increasing access to medical oncology consultation in older patients with stage II-IIIA non-small-cell lung cancer

Wang, Jue; Kuo, Yong Fang; Freeman, Jean L.

doi:10.1007/s12032-007-9003-5

Cited by 12 publications

(2 citation statements)

References 20 publications

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“…Several studies have found that MDT management plans show good concordance with evidence based guidelines [9,11,38], and that MDTs increase overall treatment rates, probably through the consideration of more patients with borderline stage or fitness for intervention [37,39,40]. Some authors have also reported improvements in survival [39,49], but could not account for confounding by other advances or improvements in the care of patients with thoracic malignancies.…”

Section: Benefits For the Patientmentioning

confidence: 99%

Multidisciplinary team management in thoracic oncology: more than just a concept?

Powell

Baldwin

2014

Eur Respir J

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Multidisciplinary team (MDT) management in thoracic oncology has been introduced over the past two decades with the aim of improving outcomes for patients. While MDT management has become the standard of care in some countries, not all healthcare systems have adopted this practice. In this article we review the history and implementation of MDT care in thoracic oncology and explore the evidence for, and challenges associated with, this system of working.There are many advantages of an MDT both to the patient, the clinicians and the wider population, but it is difficult to demonstrate a beneficial effect on outcomes such as treatment rates or survival given the substantial number of coexistent changes in the management of thoracic malignancies over the same time period. There are also some disadvantages associated with MDT working, particularly the costs of setting up the service and the time commitment from each of the healthcare professionals involved. Barriers to effective MDT working include poor attendance by some specialists, inadequate preparation and poor quality information about the patient. Variation in quality of MDTs has been reported so it is important that practice is monitored and areas for improvement identified. @ERSpublications Multidisciplinary teams ensure patients receive timely specialist input but effect on treatment/ survival is hard to show

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Section: Benefits For the Patientmentioning

confidence: 99%

Multidisciplinary team management in thoracic oncology: more than just a concept?

Powell

Baldwin

2014

Eur Respir J

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“…As there exists no standard protocol in how to define providers and locations, the definitions vary across studies. Some have used specialty codes to identify providers [ 14 – 16 ]. One paper used billing codes [ 17 ] and another used both billing and specialty codes [ 5 ].…”

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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Multidisciplinary Approach to Lung Cancer Care

Bilfinger,

Santore,

Nemesure

2023

Respiratory Medicine

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Increasing access to medical oncology consultation in older patients with stage II-IIIA non-small-cell lung cancer

Cited by 12 publications

References 20 publications

Multidisciplinary team management in thoracic oncology: more than just a concept?

Multidisciplinary team management in thoracic oncology: more than just a concept?

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

Multidisciplinary Approach to Lung Cancer Care

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