Diversity in the Cancer Care Workforce

癌症护理人员队伍的多样性

• 批准号: 10655717
• 负责人: Dowin Boatright
• 金额: $ 85.88万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-23 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10655717
• 关键词: Address; Affect; American Medical Association; Area; Association of American Medical Colleges; Black race; Businesses; Caring; Characteristics; Clinical Data; Colorectal Cancer; Data; Data Linkages; Data Sources; Diagnosis; Disparity; Early Diagnosis; Equity; Ethnic Origin; General Population; Geographic Locations; Geography; Goals; Guidelines; Health system; Healthcare Market; Hematology; Individual; Knowledge; Latinx; Latinx population; Literature; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Medicare; Medicine; Methods; Oncologist; Oncology; Outcome; Patient Care; Patient-Focused Outcomes; Patients; Patterns of Care; Performance; Physicians; Play; Population; Provider; Public Health; Quality of Care; Race; Research; Retrospective Studies; Role; SEER Program; Science; Screening for cancer; Stage at Diagnosis; Structural Racism; Training Programs; Variant; Work; cancer care; cancer diagnosis; cancer health disparity; cancer therapy; clinical care; contextual factors; end of life; end of life care; ethnic disparity; ethnic diversity; geographic difference; improved; indexing; individual patient; malignant breast neoplasm; medical specialties; neoplasm registry; novel; novel strategies; population based; racial disparity; racial diversity; sociodemographics

Significance: The racial and ethnic distribution of the cancer workforce contrasts starkly with that of the general population. Only 2-3% of oncologists identify as Black or Latinx, compared to 13% and 18% of the U.S. population, respectively. While evidence from the business literature suggests that diversity in teams impacts organizational performance, it is not known whether provider team diversity as well as patient-provider racial and ethnic concordance is associated with quality of cancer-related care and outcomes. If the diversity of teams (physician patient-sharing networks) does indeed improve cancer care, this benefit could improve care for all patients, regardless of the individual patient's race or ethnicity or the race or ethnicity of their provider. Objective: Our over-arching goal is to generate actionable evidence to inform efforts to improve cancer workforce diversity and increase equity in cancer care. Our hypothesis is that the racial and ethnic representation of the oncology workforce varies across regions and patient-sharing networks and that this variation is associated with clinical care. Previously, addressing this knowledge gap has not been possible due to a lack of available data combining physician race and ethnicity with patient clinical data. Specific Aims: We propose a retrospective study using a novel data linkage between the American Medical Association; Association of American Medical Colleges; Surveillance, Epidemiology and End Results population-based cancer registries; and Medicare data to address the following aims: (Aim 1) To ethnic and sharing and regions patient-sharing or assess changes in racial and diversity of the cancer physician and trainee workforce between 2015 and 2020, according to specialty regional healthcare market and ( Aim 1A ) to assess the racial and ethnic diversity of physician patient- networks providing cancer care during the period 2015 – 2020; ( Aim 2 ) To assess variation in racial ethnic representativeness of the oncology workforce across specialty, physician networks, and geographic and (Aim 2A) to identify whether underrepresented in medicine (URM) physicians, as well as physician networks containing a higher proportion of URM physicians, are more likely to care for Black Latinx patients with cancer; ( Aim 3 )To assess geographic and health system contextual factors (e.g. health system factors, area sociodemographics, and structural racism) associated with physician diversity within physician patient-sharing networks; (Aim 4) Among patients diagnosed with invasive lung, prostate, breast, or colorectal cancer during 2015-2019, to networks Receipt assess the association between the racial diversity of their physician , and ( Aim 4A) Early stage at diagnosis for patients with colorectal or breast cancer, ( Aim 4B ) of guideline-concordant cancer treatment, and ( Aim 4C) Quality of end of life care. Through this study, we will create a novel data linkage, and incorporate network science methods to further our understanding of the cancer physician workforce and to identify whether physician team diversity may serve as a previously unidentified mechanism of reducing racial and ethnic disparities in cancer outcomes.

意义：癌症劳动力的种族和民族分布与 普通人口。只有2%-3%的肿瘤学家认为自己是黑人或拉丁裔，而美国的这一比例分别为13%和18%。 分别是人口。虽然商业文献中的证据表明，团队中的多样性会影响 组织绩效，尚不清楚提供者团队的多样性以及患者-提供者的种族 种族和谐性与癌症相关护理的质量和结果有关。如果团队的多样性 (医生患者共享网络)确实改善了癌症护理，这一好处可以改善对所有人的护理 患者，无论个别患者的种族或民族，或其提供者的种族或民族。 目标：我们的总体目标是产生可操作的证据，为改善癌症的努力提供信息 劳动力多样化和增加癌症护理的公平性。我们的假设是，种族和民族 肿瘤学工作人员的代表性因地区和患者共享网络而异，这 变异与临床护理有关。以前，解决这一知识鸿沟是不可能的 由于缺乏将医生种族和民族与患者临床数据相结合的可用数据。具体目标： 我们提出了一项回溯性研究，使用了美国医学会之间的一种新的数据联系； 美国医学院协会；以人群为基础的监测、流行病学和结局 癌症登记；和医疗保险数据，以实现以下目标：(目标1) 民族 和 共享 和 区域 患者共享 或 评估种族和性别的变化 根据专科统计，2015至2020年间癌症医生和实习医生队伍的多样性 区域医疗保健市场和(目标1A)评估内科患者的种族和民族多样性- 2015-2020年期间提供癌症护理的网络；(目标2)评估种族差异 跨专业、医生网络和地域的肿瘤学劳动力的种族代表性 以及(目标2A)确定是否在医学(URM)医生以及医生中代表性不足 网络中包含更高比例的URM医生，更有可能照顾黑人 拉美裔癌症患者；(目标3)评估地理和卫生系统背景因素(例如健康状况 系统因素、地区社会人口统计和结构性种族主义)与医生多样性有关 医生患者共享网络；(目标4)诊断为侵袭性肺、前列腺、乳腺或 2015-2019年结直肠癌，至 网络 收据 评估他们医生的种族多样性之间的联系 ，和(目标4A)结直肠癌或乳腺癌患者的早期诊断(目标4B) 符合指导方针的癌症治疗，以及(目标4C)临终关怀的质量。通过这件事 研究中，我们将创建一种新颖的数据链接，并结合网络科学方法来进一步 了解癌症医生队伍并确定医生团队的多样性是否可以作为 一种以前未知的减少癌症结果中种族和民族差异的机制。