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

项目摘要（请参阅说明）： 癌症治疗中的种族差异得到很好的描述，但了解得很糟糕。尽管大多数专家认为获得护理的机会会导致这些差异，但易受伤害的人口的访问是一个复杂的多维过程，由于保险范围或旅行时间的衡量标准而被捕获不足。在此应用程序中，我们建议以我们先前的研究种族差异，前列腺癌的治疗以及获得护理的机会来研究医疗保健获取对前列腺癌治疗中种族差异的多维图片的贡献。 我们将收集有关在大费城地区8个县的基于人口的男性样本（n = 3,000）的基于人群的样本，以及构成前列腺癌治疗的泌尿外科医生和放射学家。我们将重点关注这一领域，因为它是拟议中心的主要重点，并且因为对城市人口中癌症护理的多个维度知之甚少。在Penchansky和Thomas的访问框架内，我们将使用患者调查，行政记录和提供者库存的数据来评估前列腺癌护理的可及性 /可用性，住宿，负担能力和可接受性。遵循Aday＆Andersen的框架，我们将创建潜在的访问和个人访问措施（一种已实现访问形式）的空间度量。我们将使用来自患者的数据以及AMA MasterFile的数据提供有关提供商董事会认证和培训的数据，将有关提供者的特征以及提供者的特征结合在一起。然后，我们将研究潜在的访问，经验丰富的访问和治疗差异以及这些影响的程度是由保险范围，社会经济地位和社区剥夺介导的程度之间的关系。据我们所知，这将是第一项通过从患者，提供者和行政来源收集信息来构建癌症护理访问癌症护理的全面，获得癌症护理的第一项研究，并利用这张照片来提高我们对癌症治疗中种族差异的理解