BACKGROUND: Patient travel distances, coupled with variation in facility-level resources, create barriers for prostate cancer care in the Veterans Health Administration integrated delivery system. For these reasons, the authors investigated the degree to which these barriers impact the quality of prostate cancer care. METHODS: The Veterans Affairs Central Cancer Registry was used to identify all men who were diagnosed with prostate cancer in 2008. Patient residence was characterized using Rural Urban Commuting Area codes. The authors then examined whether rural residence, compared with urban residence, was associated with less access to cancer-related resources and worse quality of care for 5 prostate cancer quality measures. RESULTS: Approximately 25% of the 11,368 patients who were diagnosed with prostate cancer in 2008 lived in either a rural area or a large town. Rural patients tended to be white (62% urban vs 86% rural) and married (47% urban vs 63% rural), and they tended to have slightly higher incomes (all P<.01) but similar tumor grade (P=.23) and stage (P=.12) compared with urban patients. Rural patients were significantly less likely to be treated at facilities with comprehensive cancer resources, although they received a similar or better quality of care for 4 of the 5 prostate cancer quality measures. The time to prostate cancer treatment was similar (rural patients vs urban patients, 96.6 days vs 105.7 days). CONCLUSIONS: Rural patients with prostate cancer had less access to comprehensive oncology resources, although they received a similar quality of care, compared with their urban counterparts in the Veterans Health Administration integrated delivery system. A better understanding of the degree to which facility factors contribute to the quality of cancer care may assist other organizations involved in rural health care delivery. This article is US. Government work and, as such, is in the public domain in the United States of America.
BACKGROUND:Patient travel distances, coupled with variation in facility-level resources, create barriers for prostate cancer care in the Veterans Health Administration integrated delivery system. For these reasons, the authors investigated the degree to which these barriers impact the quality of prostate cancer care. METHODS: The Veterans Affairs Central Cancer Registry was used to identify all men who were diagnosed with prostate cancer in 2008. Patient residence was characterized using Rural Urban Commuting Area codes. The authors then examined whether rural residence, compared with urban residence, was associated with less access to cancer-related resources and worse quality of care for 5 prostate cancer quality measures. RESULTS: Approximately 25% of the 11,368 patients who were diagnosed with prostate cancer in 2008 lived in either a rural area or a large town. Rural patients tended to be white (62% urban vs 86% rural) and married (47% urban vs 63% rural), and they tended to have slightly higher incomes (all P<.01) but similar tumor grade (P=.23) and stage (P=.12) compared with urban patients. Rural patients were significantly less likely to be treated at facilities with comprehensive cancer resources, although they received a similar or better quality of care for 4 of the 5 prostate cancer quality measures. The time to prostate cancer treatment was similar (rural patients vs urban patients, 96.6 days vs 105.7 days). CONCLUSIONS: Rural patients with prostate cancer had less access to comprehensive oncology resources, although they received a similar quality of care, compared with their urban counterparts in the Veterans Health Administration integrated delivery system. A better understanding of the degree to which facility factors contribute to the quality of cancer care may assist other organizations involved in rural health care delivery. This article is US. Government work and, as such, is in the public domain in the United States of America.
Authors: Davide Gori; Rajendra Dulal; Douglas W Blayney; James D Brooks; Maria P Fantini; Kathryn M McDonald; Tina Hernandez-Boussard Journal: Jt Comm J Qual Patient Saf Date: 2018-09-18
Authors: Leah L Zullig; Kellie J Sims; Rebecca McNeil; Christina D Williams; George L Jackson; Dawn Provenzale; Michael J Kelley Journal: Mil Med Date: 2017-07 Impact factor: 1.437
Authors: Danil V Makarov; Elaine Y C Hu; Dawn Walter; R Scott Braithwaite; Scott Sherman; Heather T Gold; Xiao-Hua Andrew Zhou; Cary P Gross; Steven B Zeliadt Journal: Health Serv Res Date: 2015-09-30 Impact factor: 3.402
Authors: Michael Fenstermaker; Sujay Paknikar; Amarnath Rambhatla; Dana A Ohl; Ted A Skolarus; James M Dupree Journal: Curr Urol Rep Date: 2017-09-18 Impact factor: 3.092
Authors: Peter S Kirk; Shail Govani; Tudor Borza; Brent K Hollenbeck; Jennifer Davis; Dean Shumway; Akbar K Waljee; Ted A Skolarus Journal: Urology Date: 2017-02-03 Impact factor: 2.649
Authors: David Schreiber; Eric B Levy; David Schwartz; Justin Rineer; Andrew Wong; Marvin Rotman; Jeffrey P Weiss Journal: Int Urol Nephrol Date: 2014-06-27 Impact factor: 2.370
Authors: Craig Evan Pollack; Michelle E Ross; Katrina Armstrong; Charles C Branas; Karin V Rhodes; Justin E Bekelman; Alicia Wentz; Christian Stillson; Archana Radhakrishnan; Enny Oyeniran; David Grande Journal: PLoS One Date: 2016-10-10 Impact factor: 3.240