NCI Community Cancer Center Program (NCCCP): Disparities in time between cancer diagnosis and treatment initiation.

Authors

null

Stephanie Teixeira-Poit

RTI International, Research Triangle Park, NC

Stephanie Teixeira-Poit, Pamela Spain, Michael T. Halpern, Kathleen M. Castro, Irene Prabhu Das, Brenda A. Adjei, Steven Clauser

Organizations

RTI International, Research Triangle Park, NC, University of Arizona College of Public Health, Tucson, AZ, National Cancer Institute, Bethesda, MD, Division of Cancer Control and Population Science, National Cancer Institute of the National Institutes of Health, Rockville, MD, National Cancer Institute, Rockville, MD, Patient-Centered Outcomes Research Institute, Washington, DC

Research Funding

No funding sources reported

Background: The National Cancer Institute Community Cancer Centers Program (NCCCP) was designed to improve care and reduce cancer disparities at community hospitals. This study examined the number of days between diagnosis and treatment for five National Quality Forum-endorsed cancer quality measures. Methods: A retrospective analysis of data from patients diagnosed and receiving breast or colon cancer treatment at 12 NCCCP sites was performed. We examined time to treatment for cancer quality measures, stratified by concordant and non-concordant patients. We compared patients diagnosed before (2006 – 2007) vs. during (2008-2013) the NCCCP period. Results:Concordant Cases. Time to treatment was significantly greater in the NCCCP vs. pre-NCCCP periods for three measures. Compared to pre-the NCCCP period, time to treatment in the NCCCP period was longer by 26 days for women with breast cancer receiving hormonal therapy (HT). Time to HT increased significantly among most patient and hospital subgroups (race, age, insurance, hospital size). Black, Medicaid, and/or uninsured patients generally had longer-than-average time to treatment for all measures when receiving guideline-concordant care. Non-Concordant Cases. Among women with breast cancer who received treatment outside the measure window, most eligible for multi-agent chemotherapy received treatment within one month after the cut-off. In contrast, a majority eligible for other cancer quality measures received treatment more than one after the cut-off. Among women who were non-concordant for HT, those with Medicare or private insurance were significantly more likely to begin HT within one month after the cut-off than were those with Medicaid. Conclusions: More than half of patients non-concordant on cancer quality measures received treatment more than one month after the treatment window. However, many were non-concordant because they were just outside the time window to be considered concordant (< 30 days), particularly Medicaid patients. Rapid reporting of quality indicators could inform targeted efforts to improve care coordination and concordance rates, particularly among certain patient subgroups.

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Abstract Details

Meeting

2016 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session B: Science of Quality

Track

Cost, Value, and Policy in Quality,Practice of Quality,Science of Quality

Sub Track

Quality Measurement

Citation

J Clin Oncol 34, 2016 (suppl 7S; abstr 279)

DOI

10.1200/jco.2016.34.7_suppl.279

Abstract #

279

Poster Bd #

L7

Abstract Disclosures

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