Comparison of US Oncologist Rurality by Practice Setting and Patients Served.
Comparison of US Oncologist Rurality by Practice Setting and Patients Served.
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DOI：
10.1001/jamanetworkopen.2023.50504
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发表时间：
2024-01-02
影响因子：
13.8
通讯作者：
Moen, Erika L.
中科院分区：
文献类型：
--
作者：
Cornelius, Sarah L.;Shaefer, Andrew P.;Wong, Sandra L.;Moen, Erika L.
本横断面研究评估了一种使用农村患者服务比例与基于实践地点的方法进行肿瘤医生乡村性分类的方法。如何准确识别为农村地区患者提供治疗的肿瘤医生？在这项对27870名肿瘤医生的横断面研究中，使用医生患者分组对医生乡村性进行分类，发现更多的肿瘤医生治疗生活在农村地区的患者，而不是仅依赖于执业地点的标准方法，同时保持高绩效和两种方法之间的公平一致性。患者分组分类方法扩展了标准分类方法，可以更准确地捕获参与农村癌症护理的肿瘤学家。对肿瘤学工作人员的研究通常根据他们的执业地点对医生的乡村性进行分类，但这可能会错过医生参与农村癌症护理的真实程度。比较一种识别参与农村癌症护理的肿瘤医生的方法，该方法使用基于实践地点的标准方法为农村患者提供服务的比例。这项横断面研究使用了2019年1月1日至12月31日期间医疗保险和医疗补助服务中心关于医疗肿瘤学家、放射肿瘤学家和外科医生治疗被诊断患有乳腺癌、结直肠癌或肺癌的医疗保险受益人的回顾性数据。数据分析时间为2023年5月至9月。比较了基于执业地点的肿瘤科医师乡村性分类的标准方法与基于农村患者服务比例的新型分类方法。该研究包括27870名肿瘤医生（71.3%男性），其中835名（3.0%）在农村地区执业。在农村执业的医生治疗农村患者的比例很高（中位数，50.0% [IQR, 16.7%-100%]）。考虑到医生患者分组的乡村性，5123名医生（18.4%）的患者分组中至少有20%的农村患者，3199名医生（11.5%）的患者至少有33%的农村患者，1996名医生（7.2%）的患者至少有50%的农村患者。使用医师患者分组对医师乡村性进行分类显示，与标准方法相比，美国参与农村癌症护理的肿瘤医生数量更多，分布更广，同时与基于实践环境的方法保持较高的绩效（曲线下面积，0.857）和公平的一致性（κ, 0.346; 95% CI, 0.323-0.369）。在这项横断面研究中，根据农村患者的比例对肿瘤医生的乡村性进行分类，发现更多的肿瘤医生治疗生活在农村地区的患者，而不是标准的执业地点方法，并且可能更准确地捕捉农村癌症医生的劳动力，因为许多医院历史上都位于更多的城市地区。这种新方法可用于改善农村癌症护理服务的未来研究。
This cross-sectional study assesses a method of classifying oncology physician rurality using proportion of rural patients served compared with a method based on practice location. How can oncology physicians providing care to patients living in rural areas be accurately identified? In this cross-sectional study of 27 870 oncology physicians, using physicians’ patient panels to classify physician rurality identified more oncology physicians treating patients living in rural areas than standard methods that rely on only practice location, while maintaining high performance and fair concordance between the 2 methods. The patient panel classification method expanded on standard classification methods and may more accurately capture oncologists involved in rural cancer care. Studies of the oncology workforce most often classify physician rurality by their practice location, but this could miss the true extent of physicians involved in rural cancer care. To compare a method for identifying oncology physicians involved in rural cancer care that uses the proportion of rural patients served with the standard method based on practice location. This cross-sectional study used retrospective Centers for Medicare & Medicaid Services encounter data on medical oncologists, radiation oncologists, and surgeons treating Medicare beneficiaries diagnosed with breast, colorectal, or lung cancer from January 1 to December 31, 2019. Data were analyzed from May to September 2023. The standard method of classifying oncologist physician rurality based on practice location was compared with a novel method of classification based on proportion of rural patients served. The study included 27 870 oncology physicians (71.3% male), of whom 835 (3.0%) practiced in a rural location. Physicians practicing in a rural location treated a high proportion of rural patients (median, 50.0% [IQR, 16.7%-100%]). When considering the rurality of physicians’ patient panels, 5123 physicians (18.4%) whose patient panel included at least 20% rural patients, 3199 (11.5%) with at least 33% rural patients, and 1996 (7.2%) with at least 50% rural patients were identified. Using a physician’s patient panel to classify physician rurality revealed a higher number and greater spread of oncology physicians involved in rural cancer care in the US than the standard method, while maintaining high performance (area under the curve, 0.857) and fair concordance (κ, 0.346; 95% CI, 0.323-0.369) with the method based on practice setting. In this cross-sectional study, classifying oncologist rurality by the proportion of rural patients served identified more oncology physicians treating patients living in rural areas than the standard method of practice location and may more accurately capture the rural cancer physician workforce, as many hospitals have historically been located in more urban areas. This new method may be used to improve future studies of rural cancer care delivery.
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DOI：
10.1097/jac.0000000000000429
发表时间：
2023-01-01
期刊：
The Journal of ambulatory care management
影响因子：
--
作者：
O'Shea, Amy M J;Haraldsson, Bjarni;Kaboli, Peter J
通讯作者：
Kaboli, Peter J
DOI：
10.1158/1055-9965.epi-17-0092
发表时间：
2017-07
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Blake KD;Moss JL;Gaysynsky A;Srinivasan S;Croyle RT
通讯作者：
Croyle RT
影响因子：
6.2
作者：
Hung, Peiyin;Deng, Songyuan;Eberth, Jan M.
通讯作者：
Eberth, Jan M.
影响因子：
2.7
作者：
Brems, Christiane;Johnson, Mark E;Roberts, Laura Weiss
通讯作者：
Roberts, Laura Weiss
影响因子：
3.4
作者：
Patterson, Davis G.;Shipman, Scott A.;Longenecker, Randall
通讯作者：
Longenecker, Randall