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Article

Disparities in Timeliness of Care for U.S. Medicare Patients Diagnosed with Cancer

1
RTI International, Washington, DC, USA
2
RTI International, Research Triangle Park, NC, USA
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2012, 19(6), 404-413; https://doi.org/10.3747/co.19.1073
Submission received: 9 September 2012 / Revised: 1 October 2012 / Accepted: 7 November 2012 / Published: 1 December 2012

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.
Keywords: neoplasms; access to health care; Medicare; health care disparities neoplasms; access to health care; Medicare; health care disparities

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MDPI and ACS Style

Halpern, M.T.; Holden, D.J. Disparities in Timeliness of Care for U.S. Medicare Patients Diagnosed with Cancer. Curr. Oncol. 2012, 19, 404-413. https://doi.org/10.3747/co.19.1073

AMA Style

Halpern MT, Holden DJ. Disparities in Timeliness of Care for U.S. Medicare Patients Diagnosed with Cancer. Current Oncology. 2012; 19(6):404-413. https://doi.org/10.3747/co.19.1073

Chicago/Turabian Style

Halpern, M.T., and D.J. Holden. 2012. "Disparities in Timeliness of Care for U.S. Medicare Patients Diagnosed with Cancer" Current Oncology 19, no. 6: 404-413. https://doi.org/10.3747/co.19.1073

APA Style

Halpern, M. T., & Holden, D. J. (2012). Disparities in Timeliness of Care for U.S. Medicare Patients Diagnosed with Cancer. Current Oncology, 19(6), 404-413. https://doi.org/10.3747/co.19.1073

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