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种族分布与 一般人口。只有2-3％的肿瘤学家将其识别为黑人或拉丁裔，而美国的13％和18％ 人口分别。虽然商业文献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多样性以及患者提供者的种族多样性 种族一致性与癌症相关的护理和结果的质量有关。如果团队的多样性 （医师分享网络）确实确实改善了癌症护理，这种好处可以改善所有人的护理 患者，无论患者的种族或种族或提供者的种族或种族或种族。 目的：我们的整理目标是产生可行的证据，以告知改善癌症的努力 劳动力多样性并增加癌症护理的股权。我们的假设是种族和种族 肿瘤学劳动力范围跨区域和患者共享网络的代表 变异与临床护理有关。以前，解决此知识差距是不可能的 由于缺乏将身体种族和种族与患者临床数据相结合的可用数据。具体目的： 我们提出了一项回顾性研究，使用美国医学协会之间的新数据联系。 美国医学院协会；监视，流行病学和最终结果基于人群 癌症登记；和Medicare数据以解决以下目的：（目标1） 种族的 和 分享 和 地区 患者分享 或者 评估种族变化和 根据专业 区域医疗保健市场和（目标1A）评估身体患者的种族和种族多样性 - 在2015年至2020年期间提供癌症护理的网络； （目标2）评估种族变化 跨专业，物理网络和地理的肿瘤学劳动力的种族代表 （目标2A）确定医学医学（URM）医生的代表性不足以及医生 包含更高比例的URM医师的网络更有可能照顾黑色 拉丁癌患者； （目标3）评估地理和卫生系统的情境因素（例如卫生 系统因素，区域社会人口统计学和结构性种族主义）与内部的身体多样性相关 身体分享的网络； （AIM 4）在被诊断为浸润性肺，前列腺，乳房或 2015 - 2019年结直肠癌 网络 收据 评估医师的种族多样性之间的关联 ，（AIM 4A）在结直肠癌或乳腺癌患者的诊断早期阶段（AIM 4B） 指南结合的癌症治疗以及（AIM 4C）生命终结质量。通过这个 研究，我们将建立一个新颖的数据链接，并结合网络科学方法以进一步 了解癌症的身体劳动力，并确定身体团队多样性是否可以作为 以前未知的机制，可以减少癌症结局中种族和种族差异。