Multidimensional access and prostate cancer treatment disparities

多维获取和前列腺癌治疗差异

• 批准号: 8352632
• 负责人: KATRINA ARMSTRONG
• 金额: $ 19.52万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-27 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8352632
• 关键词: Address; Area; Board Certification; Caring; Characteristics; Clinical; Complex; County; Data; Diagnosis; Dimensions; Disadvantaged; Equipment and supply inventories; Health Services Accessibility; Healthcare; Individual; Instruction; Insurance Coverage; Malignant neoplasm of prostate; Measures; Mediating; Minority; Neighborhoods; Outcome; Patient Preferences; Patients; Philadelphia; Physicians; Population; Process; Prostatectomy; Provider; Quality of Care; Race; Radiation; Radiation Oncologist; Radiation Oncology; Records; Reporting; Research; Sampling; Socioeconomic Status; Source; Surveys; Time; Training; Travel; Urban Population; Urologist; Urology; Vulnerable Populations; active method; cancer care; cancer therapy; density; deprivation; experience; health disparity; improved; interest; men; population based; racial difference; socioeconomics

PROJECT SUMMARY (See instructions): Racial disparities in cancer treatment are well described but poorly understood. Although most experts believe that access to care contributes to these disparities, access for vulnerable populations is a complex, multidimensional process that is inadequately captured by measures of insurance coverage or travel time. In this application, we propose to build upon our prior researching racial disparities, prostate cancer treatment and access to care to investigate the contribution of a multidimensional picture of health care access to racial differences in prostate cancer treatment. We will collect primary data on a population based sample of men diagnosed with localized prostate cancer (N=3,000) in 8 counties in the Greater Philadelphia area and on the urologists and radiation oncologists who form their access to prostate cancer treatment. We will focus on this area as it is the primary focus of the proposed center and because the multiple dimensions of cancer care in urban populations are poorly understood. Building on the access framework of Penchansky and Thomas, we will assess the accessibility /availability, accommodation, affordability, & acceptability of prostate cancer care, using data from a patient survey, administrative records, & a provider inventory. Following the framework of Aday & Andersen, we will create spatial measures of potential access & individual measures of experienced access (a form of realized access). We will incorporate information about the characteristics of providers using data from patients about their experiences, as well as data from the AMA masterfile about provider board certification and training. We will then examine the relationships between potential access, experienced access, & differences in treatment as well as the degree to which these effects are mediated by insurance coverage, socioeconomic status & neighborhood deprivation. To our knowledge, this will be the first study to construct a comprehensive, multi-dimensional picture of access to cancer care by collecting information from patients, providers & administrative sources & to use this picture to improve our understanding of a racial difference in cancer treatment

项目概述（见说明）：