Lisa D DiMartino1, Justin Kirschner2, George L Jackson3,4, Michelle A Mollica5, Lisa M Lines2,6. 1. RTI International, Research Triangle Park, NC, USA. ldimartino@rti.org. 2. RTI International, Research Triangle Park, NC, USA. 3. Durham Veterans Affairs Health Care System, Durham, NC, USA. 4. Duke University, Durham, NC, USA. 5. National Cancer Institute, Rockville, MD, USA. 6. University of Massachusetts Medical School, Worcester, MA, USA.
Abstract
PURPOSE: Cancer patients' care experiences encompass the range of interactions with the health care system and are an important indicator of care quality, which may influence survival outcomes. This study evaluates relationships between care experiences and survival using a large, nationally representative sample of cancer patients. METHODS: We used linked SEER (Surveillance Epidemiology and End Results)-CAHPS (Consumer Assessment of Healthcare Providers and Systems) data to identify people diagnosed 8/2006-12/2013, focusing on 10 solid tumor cancer sites with the highest mortality rates among those > 65. CAHPS measures included 5 global ratings and 3 composite scores. We used survey-weighted Cox proportional hazard models comparing survival time for those who had lower (0-8) vs higher ratings (9-10) and lower (0-89) vs higher (90-100) composite scores, adjusting for case-mix and additional covariates. RESULTS: We identified 2,263 eligible people; 26% died by 5-year post-survey completion or end of follow-up (12/31/2017). We found lower Prescription Drug Plan (PDP) ratings were significantly associated with lower mortality (adjusted HR = 0.67, p = 0.03). Lower Getting Needed Care scores were also significantly associated with lower mortality (adjusted HR = 0.79, p = 0.04). For other care experience measures, general health status, cancer stage, and comorbidities were more predictive of survival (p < .05). CONCLUSIONS: Except for PDP and Getting Needed Care, survival was similar for those with worse versus better care experiences. Patients with poorer cancer prognoses may perceive better services from their drug plan and more responsive care from clinical providers compared to those with better prognoses. Further research is needed examining processes underlying perceptions of care experiences and survival.
PURPOSE: Cancer patients' care experiences encompass the range of interactions with the health care system and are an important indicator of care quality, which may influence survival outcomes. This study evaluates relationships between care experiences and survival using a large, nationally representative sample of cancer patients. METHODS: We used linked SEER (Surveillance Epidemiology and End Results)-CAHPS (Consumer Assessment of Healthcare Providers and Systems) data to identify people diagnosed 8/2006-12/2013, focusing on 10 solid tumor cancer sites with the highest mortality rates among those > 65. CAHPS measures included 5 global ratings and 3 composite scores. We used survey-weighted Cox proportional hazard models comparing survival time for those who had lower (0-8) vs higher ratings (9-10) and lower (0-89) vs higher (90-100) composite scores, adjusting for case-mix and additional covariates. RESULTS: We identified 2,263 eligible people; 26% died by 5-year post-survey completion or end of follow-up (12/31/2017). We found lower Prescription Drug Plan (PDP) ratings were significantly associated with lower mortality (adjusted HR = 0.67, p = 0.03). Lower Getting Needed Care scores were also significantly associated with lower mortality (adjusted HR = 0.79, p = 0.04). For other care experience measures, general health status, cancer stage, and comorbidities were more predictive of survival (p < .05). CONCLUSIONS: Except for PDP and Getting Needed Care, survival was similar for those with worse versus better care experiences. Patients with poorer cancer prognoses may perceive better services from their drug plan and more responsive care from clinical providers compared to those with better prognoses. Further research is needed examining processes underlying perceptions of care experiences and survival.
Authors: Nadia A Nabulsi; Ali Alobaidi; Brian Talon; Alemseged A Asfaw; Jifang Zhou; Lisa K Sharp; Karen Sweiss; Pritesh R Patel; Naomi Y Ko; Brian C-H Chiu; Gregory S Calip Journal: Cancer Causes Control Date: 2020-04-30 Impact factor: 2.506
Authors: Lisa M Lines; Julia Cohen; Michael T Halpern; Ashley Wilder Smith; Erin E Kent Journal: Cancer Causes Control Date: 2019-08-17 Impact factor: 2.506
Authors: Anthony Jerant; Kevin Fiscella; Joshua J Fenton; Elizabeth M Magnan; Alicia Agnoli; Peter Franks Journal: J Gen Intern Med Date: 2019-05-29 Impact factor: 5.128
Authors: Xiao Xu; Eugenia Buta; Rebecca Anhang Price; Marc N Elliott; Ron D Hays; Paul D Cleary Journal: Health Serv Res Date: 2014-12-07 Impact factor: 3.402
Authors: Marc N Elliott; Amelia M Haviland; Paul D Cleary; Alan M Zaslavsky; Donna O Farley; David J Klein; Carol A Edwards; Megan K Beckett; Nate Orr; Debra Saliba Journal: J Am Geriatr Soc Date: 2013-02-04 Impact factor: 5.562
Authors: Neetu Chawla; Matthew Urato; Anita Ambs; Nicola Schussler; Ron D Hays; Steven B Clauser; Alan M Zaslavsky; Kayo Walsh; Margot Schwartz; Michael Halpern; Sarah Gaillot; Elizabeth H Goldstein; Neeraj K Arora Journal: J Gen Intern Med Date: 2015-01-14 Impact factor: 6.473
Authors: Kathleen A Cronin; Andrew J Lake; Susan Scott; Recinda L Sherman; Anne-Michelle Noone; Nadia Howlader; S Jane Henley; Robert N Anderson; Albert U Firth; Jiemin Ma; Betsy A Kohler; Ahmedin Jemal Journal: Cancer Date: 2018-05-22 Impact factor: 6.860