Journal article
Diagnosing Provider, Referral Patterns, Facility Type, and Patient Satisfaction Among Iowa Rectal Cancer Patients
Journal of gastrointestinal cancer, Vol.55(1), pp.355-364
03/2024
DOI: 10.1007/s12029-023-00963-y
PMCID: PMC11611274
PMID: 37646879
Abstract
PURPOSERectal cancer treatment at high-volume centers is associated with higher likelihood of guideline-concordant care and improved outcomes. Whether rectal cancer patients are referred for treatment at high-volume hospitals may depend on diagnosing provider specialty. We aimed to determine associations of diagnosing provider specialty with treating provider specialty and characteristics of the treating facility for rectal cancer patients in Iowa. METHODSRectal cancer patients identified using the Iowa Cancer Registry completed a mailed survey on their treatment experience and decision-making process. Provider type was defined by provider specialty and whether the provider referred patients elsewhere for surgery. Multivariable-adjusted logistic regression models were used to examine predictors of being diagnosed by a general surgeon who also performed the subsequent surgery. RESULTSOf 417 patients contacted, 381 (76%) completed the survey; our final analytical sample size was 267. Half of respondents were diagnosed by a gastroenterologist who referred them elsewhere; 30% were diagnosed by a general surgeon who referred them elsewhere, and 20% were diagnosed by a general surgeon who performed the surgery. Respondents who were ≥ 65 years old, had less than a college education, and who made < $50,000 per year were more likely to be diagnosed by a general surgeon who performed surgery. In multivariable-adjusted models, respondents diagnosed and treated by the same general surgeon were more likely to have surgery at hospitals with low annual colorectal cancer surgery volume and less likely to be satisfied with their care. CONCLUSIONSAmong rectal cancer patients in Iowa, respondents who were diagnosed and treated by the same provider were less likely to get treatment at a high-volume facility. This study informs the importance of provider referral in centralization of rectal cancer care.
Details
- Title: Subtitle
- Diagnosing Provider, Referral Patterns, Facility Type, and Patient Satisfaction Among Iowa Rectal Cancer Patients
- Creators
- Sarah Nash - University of IowaKristin Weeks - The Ohio State UniversityAmanda R Kahl - University of IowaNatalie J Del Vecchio - Fred Hutch Cancer CenterKristina Guyton - University of IowaMary Charlton - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of gastrointestinal cancer, Vol.55(1), pp.355-364
- DOI
- 10.1007/s12029-023-00963-y
- PMID
- 37646879
- PMCID
- PMC11611274
- NLM abbreviation
- J Gastrointest Cancer
- ISSN
- 1941-6628
- eISSN
- 1941-6636
- Grant note
- name: National Cancer Institute, award: HHSN261201800012I/ HHSN26100001, HHSN261201800012I/ HHSN26100001, HHSN261201800012I/ HHSN26100001; DOI: 10.13039/100000002, name: National Institutes of Health, award: T32 CA 148062
- Language
- English
- Electronic publication date
- 08/30/2023
- Date published
- 03/2024
- Academic Unit
- Epidemiology; Surgery; Center for Social Science Innovation; Community and Behavioral Health
- Record Identifier
- 9984459412102771
Metrics
7 Record Views