Michigan Oncology Quality Consortium, Ann Arbor, MI
Louise Bedard, Gabrielle Steinl, Jamie Lindsay, Jennifer Yanchula, Chandler McLeod, Stacie Myers, Jennifer J. Griggs
Background: The purpose of this study was to investigate the relationships between new patient volume per oncologist, the availability of a social worker, and the capacity to provide psychosocial care. Methods: Community practices within Michigan Oncology Quality Consortium (MOQC), a statewide quality collaborative, completed NCI’s 10-item Cancer Psychosocial Care Matrix (CPCM). The CPCM speaks to communication, assessment, coordination, training, and outcomes and quality, each on a separate Likert scale. Analyses describe the ability to meet psychosocial care and the availability of a social worker, new patients/full time oncologist, payer mix, and percent minorities. Results: To date,15 of 47 practices (32%) completed the CPCM. We report on 4 measures with sizeable variation between practices. Scores were the highest on the ability to communicate the importance of psychosocial care and implementing a plan (scale of 1 – 3; mean of 2.36, standard deviation, SD 0.72; mean of 1.79, SD 0.89). The lowest scores were related to linking patients with services and offering provider education (scale of 1 – 5: mean of 2.18, SD 1.08; mean of 2.20, SD 0.94). Linear regression showed an association with number of patients/oncologist and the ability to provide staff training of effective patient/provider communication and monitoring this activity’s impact. For every 100-person increase in the number of patients/oncologist, there was a -0.16 (p = 0.046) rating difference in staff training and a -0.25 (p = 0.006) rating difference to monitor the communication’s effect. A dedicated social worker was present in 3 practices. Regression analysis showed a relationship between a social worker and recognizing (p=0.02) and addressing psychosocial care (p<0.001). There was wide variation in payer mix and percent minorities but no association between the dependent variables and these characteristics. Conclusions: Community practices with a larger volume of new patients/oncologist/year are less likely to provide staff training and monitoring on psychosocial communication. In this sample, payer mix and racial composition are not associated with a practice’s ability to deliver psychosocial care.
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