Gery P Guy1, Lisa C Richardson. 1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS K-55, Atlanta, GA 30341, USA. Irm2@cdc.gov
Abstract
OBJECTIVES: To examine the characteristics of patients with cancer and their visits to outpatient, office-based physicians; to analyze any differences between visits to oncologists and visits to other physicians; and to examine the effect of patient, practice, visit, and geographic characteristics on the length of time patients with cancer spend with physicians during office-based visits. METHODS: We examined a total of 2470 patient office visits to nonfederally employed physicians from the 2006 and 2007 National Ambulatory Medical Care Survey. We performed descriptive analyses to examine the characteristics of patients with cancer by physician specialty. We conducted multivariate analyses using a generalized linear model to examine the relationship between visit duration and patient, practice, visit, and geographic characteristics. RESULTS: Forty-two percent of patients with cancer visited an oncologist. Females, females diagnosed with breast cancer, and individuals with advanced-stage cancer were more likely to visit an oncologist. Patients who visited oncologists were more likely to receive an anticancer drug, radiation therapy, and an increased number of diagnostic/screening services than those visiting other physicians. The mean duration of patient visits was 22.9 minutes. Higher percentages of performance-based compensation and capitation rates were associated with visits 4.4 minutes and 5.7 minutes shorter, respectively. CONCLUSIONS: Higher use of performance-based payment mechanisms and capitated arrangements is associated with a decrease in the amount of time physicians spend with their patients with cancer. It is unclear whether shorter visit times impact the quality of medical care provided or whether physicians in these settings have become more proficient in caring for their patients.
OBJECTIVES: To examine the characteristics of patients with cancer and their visits to outpatient, office-based physicians; to analyze any differences between visits to oncologists and visits to other physicians; and to examine the effect of patient, practice, visit, and geographic characteristics on the length of time patients with cancer spend with physicians during office-based visits. METHODS: We examined a total of 2470 patient office visits to nonfederally employed physicians from the 2006 and 2007 National Ambulatory Medical Care Survey. We performed descriptive analyses to examine the characteristics of patients with cancer by physician specialty. We conducted multivariate analyses using a generalized linear model to examine the relationship between visit duration and patient, practice, visit, and geographic characteristics. RESULTS: Forty-two percent of patients with cancer visited an oncologist. Females, females diagnosed with breast cancer, and individuals with advanced-stage cancer were more likely to visit an oncologist. Patients who visited oncologists were more likely to receive an anticancer drug, radiation therapy, and an increased number of diagnostic/screening services than those visiting other physicians. The mean duration of patient visits was 22.9 minutes. Higher percentages of performance-based compensation and capitation rates were associated with visits 4.4 minutes and 5.7 minutes shorter, respectively. CONCLUSIONS: Higher use of performance-based payment mechanisms and capitated arrangements is associated with a decrease in the amount of time physicians spend with their patients with cancer. It is unclear whether shorter visit times impact the quality of medical care provided or whether physicians in these settings have become more proficient in caring for their patients.
Authors: Tamandra Morgan; Johanna Schmidt; Christy Haakonsen; Janine Lewis; Maria Della Rocca; Stephanie Morrison; Barbara Biesecker; Kimberly A Kaphingst Journal: JMIR Res Protoc Date: 2014-02-24