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Association of Physician Referrals with Timely Cancer Care Using Tumor Registry and Claims Data.

Publication ,  Journal Article
Schiaffino, MK; Murphy, JD; Nalawade, V; Nguyen, P; Shakya, H
Published in: Health equity
January 2022

More Americans are being screened for and more are surviving colorectal cancer due to advanced treatments and better quality of care; however, these benefits are not equitably distributed among diverse or older populations. Differential care delivery outcomes are driven by multiple factors, including access to timely treatment that comes from high-quality care coordination. Providers help ensure such coordinated care, which includes timely referrals to specialists. Variation in referrals between providers can also result in differences in treatment plans and outcomes. Patients who are more often referred between the same diagnosing and treating providers may benefit from more timely care compared to those who are not. Our objective is to examine patterns of referral, or patient-sharing networks (PSNs), and our outcome, treatment delay of 30-days (yes/no). We hypothesize that if a patient is in a PSN they will have lower odds of a 30-day treatment initiation delay. Our observational population-based analysis using the National Cancer Institute (NCI)-linked tumor registry and Medicare claims database includes records for 27,689 patients diagnosed with colorectal cancer from 2001 to 2013, and treated with either chemotherapy, radiotherapy, or surgery. We modeled the adjusted odds of a delay and found 17.04% of patients experienced a 30-day delay in initial treatment. Factors that increased odds of a delay were lack of membership in a PSN (adjusted odds ratio [AOR]: 2.20; 95% confidence interval [CI]: 1.71-2.84), racial/ethnic minority status, and having multiple comorbidities. Provider characteristics significantly associated with greater odds of a delay were if dyads were not in the same facility (AOR: 1.95; 95% CI: 1.81-2.10), if providers were different genders, most notably male (diagnosing) and female (treating) [AOR: 1.23; 95% CI: 1.08-1.40, p = 0.0015]. PSNs appear to be associated with reduced of a care delay. The associations observed in our study address the demand for developing multilevel interventions to improve the delivery and coordination of high-quality of care for older cancer patients.

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Published In

Health equity

DOI

EISSN

2473-1242

ISSN

2473-1242

Publication Date

January 2022

Volume

6

Issue

1

Start / End Page

106 / 115

Related Subject Headings

  • 4206 Public health
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schiaffino, M. K., Murphy, J. D., Nalawade, V., Nguyen, P., & Shakya, H. (2022). Association of Physician Referrals with Timely Cancer Care Using Tumor Registry and Claims Data. Health Equity, 6(1), 106–115. https://doi.org/10.1089/heq.2021.0089
Schiaffino, Melody K., James D. Murphy, Vinit Nalawade, Phuong Nguyen, and Holly Shakya. “Association of Physician Referrals with Timely Cancer Care Using Tumor Registry and Claims Data.Health Equity 6, no. 1 (January 2022): 106–15. https://doi.org/10.1089/heq.2021.0089.
Schiaffino MK, Murphy JD, Nalawade V, Nguyen P, Shakya H. Association of Physician Referrals with Timely Cancer Care Using Tumor Registry and Claims Data. Health equity. 2022 Jan;6(1):106–15.
Schiaffino, Melody K., et al. “Association of Physician Referrals with Timely Cancer Care Using Tumor Registry and Claims Data.Health Equity, vol. 6, no. 1, Jan. 2022, pp. 106–15. Epmc, doi:10.1089/heq.2021.0089.
Schiaffino MK, Murphy JD, Nalawade V, Nguyen P, Shakya H. Association of Physician Referrals with Timely Cancer Care Using Tumor Registry and Claims Data. Health equity. 2022 Jan;6(1):106–115.

Published In

Health equity

DOI

EISSN

2473-1242

ISSN

2473-1242

Publication Date

January 2022

Volume

6

Issue

1

Start / End Page

106 / 115

Related Subject Headings

  • 4206 Public health