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The Association Between Oncology Outreach and Timely Treatment for Rural Patients with Breast Cancer: A Claims-Based Approach.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2024 Jul; Vol. 31 (7), pp. 4349-4360. Date of Electronic Publication: 2024 Mar 27. - Publication Year :
- 2024
-
Abstract
- Background: Oncology outreach is a common strategy for increasing rural access to cancer care, where traveling oncologists commute across healthcare settings to extend specialized care. Examining the extent to which physician outreach is associated with timely treatment for rural patients is critical for informing outreach strategies.<br />Methods: We identified a 100% fee-for-service sample of incident breast cancer patients from 2015 to 2020 Medicare claims and apportioned them into surgery and adjuvant therapy cohorts based on treatment history. We defined an outreach visit as the provision of care by a traveling oncologist at a clinic outside of their primary hospital service area. We used hierarchical logistic regression to examine the associations between patient receipt of preoperative care at an outreach visit (preoperative outreach) and > 60-day surgical delay, and patient receipt of postoperative care at an outreach visit (postoperative outreach) and > 60-day adjuvant delay.<br />Results: We identified 30,337 rural-residing patients who received breast cancer surgery, of whom 4071 (13.4%) experienced surgical delay. Among surgical patients, 14,501 received adjuvant therapy, of whom 2943 (20.3%) experienced adjuvant delay. In adjusted analysis, we found that patient receipt of preoperative outreach was associated with reduced odds of surgical delay (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.61-0.91); however, we found no association between patient receipt of postoperative outreach and adjuvant delay (OR 1.04, 95% CI 0.85-1.25).<br />Conclusions: Our findings indicate that preoperative outreach is protective against surgical delay. The traveling oncologists who enable such outreach may play an integral role in catalyzing the coordination and timeliness of patient-centered care.<br /> (© 2024. Society of Surgical Oncology.)
- Subjects :
- Humans
Female
Aged
United States
Time-to-Treatment statistics & numerical data
Medical Oncology statistics & numerical data
Follow-Up Studies
Aged, 80 and over
Prognosis
Fee-for-Service Plans
Mastectomy
Breast Neoplasms surgery
Breast Neoplasms therapy
Rural Population statistics & numerical data
Medicare statistics & numerical data
Health Services Accessibility statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 31
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 38538822
- Full Text :
- https://doi.org/10.1245/s10434-024-15195-y