Regional differences in recommended cancer treatment for the elderly

被引:7
作者
Ho, Vivian [1 ,2 ,3 ]
Ku-Goto, Meei-Hsiang [1 ]
Zhao, Hui [4 ]
Hoffman, Karen E. [4 ]
Smith, Benjamin D. [4 ]
Giordano, Sharon H. [5 ]
机构
[1] Rice Univ, Baker Inst Publ Policy, 6100 Main St MS-40, Houston, TX 77005 USA
[2] Rice Univ, Dept Econ, 6100 Main St MS-40, Houston, TX 77005 USA
[3] Baylor Coll Med, Dept Med, One Baylor Plaza, Houston, TX 77030 USA
[4] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA
[5] Univ Texas MD Anderson Canc Ctr, Dept Hlth Serv Res, 1400 Pressler St,Unit 1444, Houston, TX 77030 USA
来源
BMC HEALTH SERVICES RESEARCH | 2016年 / 16卷
关键词
Treatment variation; Specialists; Guidelines; Colorectal cancer; Pancreatic resection; Prostate cancer; LOCOREGIONAL PANCREATIC-CANCER; LOCALIZED PROSTATE-CANCER; BREAST-CANCER; RADICAL PROSTATECTOMY; COLORECTAL-CANCER; GEOGRAPHIC-VARIATION; PRACTICE GUIDELINES; UNITED-STATES; CARE; POPULATION;
D O I
10.1186/s12913-016-1534-z
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Little is known about regional variation in cancer treatment and its determinants. We compare rates of adherence to treatment guidelines for elderly patients across Texas and whether local specialist supply is an important determinant of treatment variation. Methods: Previous literature reviewed indicated 7 recommended courses of treatment for colorectal, pancreatic, and prostate cancer. We analyzed Texas Cancer Registry data linked with Medicare claims for the years 2004 to 2007 to study patients with these cancers. We tested for unadjusted and adjusted differences in treatment rates across 22 hospital referral regions (HRR). We tested whether variation in the local supply of specialists treating each cancer was an important determinant of treatment. Results: We found significant differences in adjusted treatment rates across regions. For removal and examination of 12+ lymph nodes with colon cancer resection, 13 of 22 HRRs had rates significantly different from the median region. For adjuvant chemotherapy for regional colon cancer, five HRRs significantly differed from the median. For prostate cancer treatment with a favorable diagnosis, nine HRRs differed from the median HRR. Of the 7 treatments, only the local availability of surgeons was an important determinant for excision of lymph nodes for colon cancer patients. Conclusions: There are significant variations across Texas for seven recommended cancer treatments. No one region has consistently higher or lower treatments than other regions, and local specialist supply is not an important predictor of treatment. Different factors may be determining regional variation in treatment rates across cancer types and treatment options.
引用
收藏
页数:11
相关论文
共 50 条
  • [21] Receipt of recommended surveillance among colorectal cancer survivors: a systematic review
    Carpentier, Melissa Y.
    Vernon, Sally W.
    Bartholomew, L. Kay
    Murphy, Caitlin C.
    Bluethmann, Shirley M.
    JOURNAL OF CANCER SURVIVORSHIP, 2013, 7 (03) : 464 - 483
  • [22] Racial and Ethnic Differences in Prostate Cancer Survivors' Perceived Engagement in Treatment Decision-Making
    Palmer, Nynikka R.
    Gregorich, Steven E.
    Livaudais-Toman, Jennifer
    Jih, Jane
    Kaplan, Celia P.
    JOURNAL OF RACIAL AND ETHNIC HEALTH DISPARITIES, 2018, 5 (06) : 1273 - 1283
  • [23] Differences in cancer survival by remoteness of residence: an analysis of data from a population-based cancer registry
    Afshar, Nina
    English, Dallas R.
    Chamberlain, James A.
    Blakely, Tony
    Thursfield, Vicky
    Farrugia, Helen
    Giles, Graham G.
    Milne, Roger L.
    CANCER CAUSES & CONTROL, 2020, 31 (07) : 617 - 629
  • [24] Discontinuation of Radiation Treatment among Medicaid-Enrolled Women with Local and Regional Stage Breast Cancer
    Ramsey, Scott D.
    Zeliadt, Steven B.
    Richardson, Lisa C.
    Pollack, Lori A.
    Linden, Hannah
    Blough, David K.
    Cheteri, Mahesh Keitheri
    Tock, Lauri
    Nagy, Krisztina
    Anderson, Nancy
    BREAST JOURNAL, 2010, 16 (01) : 20 - 27
  • [25] Cancer screening practices in elderly with dementia
    Chapelet, Guillaume
    Berrut, Gilles
    Bourbouloux, Emmanuelle
    Campone, Mario
    Derkinderen, Pascal
    de Decker, Laure
    GERIATRIE ET PSYCHOLOGIE NEUROPSYCHIATRIE DE VIEILLISSEMENT, 2015, 13 (02): : 133 - 140
  • [26] RACIAL DIFFERENCES IN PROSTATE CANCER TREATMENT: THE ROLE OF SOCIOECONOMIC STATUS
    Watson, Megan
    Grande, David
    Radhakrishnan, Archana
    Mitra, Nandita
    Ward, Katelyn R.
    Pollack, Craig Evan
    ETHNICITY & DISEASE, 2017, 27 (03) : 201 - 208
  • [27] Treatment of colorectal cancer in elderly patients
    Krzemieniecki, Krzysztof
    ONCOLOGY IN CLINICAL PRACTICE, 2012, 8 (02): : 60 - 64
  • [28] Treatment of advanced colorectal cancer in the elderly
    Bruce, C.
    Koehne, C.-H.
    Audisio, R. A.
    EJSO, 2007, 33 : S84 - S87
  • [29] Missed Opportunities for Loco-Regional Treatment of Elderly Women with Breast Cancer
    Nirmala Bhoo-Pathy
    Nanthini Balakrishnan
    Mee-Hoong See
    Nur Aishah Taib
    Cheng-Har Yip
    World Journal of Surgery, 2016, 40 : 2913 - 2921
  • [30] Physical functioning and psychological morbidity among regional and rural cancer survivors: A report from a regional cancer centre
    Lashbrook, Mari
    Bernardes, Christina M.
    Kirshbaum, Marilynne N.
    Valery, Patricia C.
    AUSTRALIAN JOURNAL OF RURAL HEALTH, 2018, 26 (03) : 211 - 219