Disparities in timeliness of care for U.S. Medicare patients diagnosed with cancer

Michael Halpern, D. J. Holden

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background Timeliness of care (rapid initiation of treatment after definitive diagnosis) is a key component of high-quality cancer treatment. The present study evaluated factors influencing timeliness of care for U.S. Medicare enrollees. Methods Data for Medicare enrollees diagnosed with breast, colorectal, lung, or prostate cancer while living in U.S. SEER (Surveillance, Epidemiology and End Results) regions in 2000-2002 were analyzed. Patients were classified as experiencing delayed treatment if the interval between diagnosis and treatment was greater than the 95th percentile for each cancer site. The impacts of patient sociodemographic, clinical, and area-based factors on the likelihood of delayed treatment were analyzed using multivariate logistic regression. Results Black patients (compared with white patients) and patients initially treated with radiation therapy or chemotherapy (rather than surgery) had a greater likelihood of treatment delays across all four cancer sites. Hispanic status, dual Medicare-Medicaid status, location of initial treatment (inpatient vs. outpatient), and stage at diagnosis also affected timeliness of care for some cancer sites. Surprisingly, area-based factors reflecting availability of cancer care services were not significantly associated with timeliness of care or were associated with greater delays in areas with greater numbers of service providers. Conclusions Multiple factors affected receipt of timely cancer care for members of the study population, all of whom had coverage of medical care services through Medicare. Because delays in treatment initiation can increase morbidity, decrease quality of life, shorten survival, and result in greater costs, prospective studies and tailored interventions are needed to address those factors among at-risk patient groups.

Original languageEnglish (US)
JournalCurrent Oncology
Volume19
Issue number6
DOIs
StatePublished - 2012
Externally publishedYes

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Medicare
Neoplasms
Therapeutics
Medicaid
Hispanic Americans
Inpatients
Colorectal Neoplasms
Lung Neoplasms
Prostatic Neoplasms
Epidemiology
Breast
Outpatients
Radiotherapy
Logistic Models
Quality of Life
Prospective Studies
Morbidity
Costs and Cost Analysis
Drug Therapy
Survival

Keywords

  • Access to health care
  • Health care disparities
  • Medicare
  • Neoplasms

ASJC Scopus subject areas

  • Oncology

Cite this

Disparities in timeliness of care for U.S. Medicare patients diagnosed with cancer. / Halpern, Michael; Holden, D. J.

In: Current Oncology, Vol. 19, No. 6, 2012.

Research output: Contribution to journalArticle

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