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患者对结直肠癌和非小细胞肺癌护理的种族和民族差异评价:一项 SEER-CAHPS 研究。

Racial and ethnic differences in patient ratings of colorectal and non-small-cell lung cancer care: A SEER-CAHPS study.

机构信息

Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

Department of Health Sciences, Furman University, Greenville, SC, USA.

出版信息

Cancer Causes Control. 2022 Sep;33(9):1125-1133. doi: 10.1007/s10552-022-01606-6. Epub 2022 Jul 21.

Abstract

PURPOSE

Although significant racial and ethnic disparities exist in colorectal and lung cancer treatment and survival, racial differences in patient-reported experience of care are not well understood. The purpose of this study was to examine differences in patient-reported ratings of colorectal and non-small-cell lung cancer care by race/ethnicity.

METHODS

Medicare beneficiaries with AJCC stage I-IV colorectal and non-small-cell lung cancer (2003-2013) who completed a Medicare Consumer Assessment of Healthcare Providers (CAHPS) survey within 5 years of cancer diagnosis were identified in the linked SEER-CAHPS dataset. Scores were compared by race/ethnicity, defined as White, Black, or any other race/ethnicity.

RESULTS

Of the 2,621 identified patients, 161 (6.1%) were Black, 2,279 (87.0%) White, and 181 (6.9%) any other race/ethnicity. Compared to White patients, Black patients were younger, had lower educational level, and had higher census tract poverty indicator (p < 0.001). Black patients rated their ability to get care quickly significantly lower than White patients (63.5 (SE 3.38) vs. 71.4 (SE 2.12), p < 0.01), as did patients of any other race/ethnicity (LS mean 66.2 (SE 2.89), p = 0.02). Patients of any other race/ethnicity reported their ability to get needed care significantly lower than White patients (LS mean 81.9 (SE 2.46) vs. 86.7 (SE 1.75), p = 0.02); however, there was no difference in ability to get needed care between Black and White patients.

CONCLUSION

Patient ratings for getting care quickly were lower in non-White patients, indicating racial disparities in perceived timeliness of care.

摘要

目的

尽管在结直肠癌和肺癌的治疗和生存方面存在显著的种族和民族差异,但患者对护理体验的种族差异尚未得到充分理解。本研究旨在检查不同种族/族裔患者对结直肠癌和非小细胞肺癌护理的报告评分差异。

方法

在 SEER-CAHPS 数据集内,确定了在癌症诊断后 5 年内完成 Medicare 消费者评估医疗保健提供者(CAHPS)调查的 AJCC 分期 I-IV 期结直肠癌和非小细胞肺癌(2003-2013 年)的 Medicare 受益人。根据种族/族裔(定义为白种人、黑种人或任何其他种族/族裔)对评分进行比较。

结果

在确定的 2621 名患者中,161 名(6.1%)为黑人,2279 名(87.0%)为白人,181 名(6.9%)为任何其他种族/族裔。与白人患者相比,黑人患者年龄较小,教育程度较低,且所在普查区贫困指标较高(p<0.001)。黑人患者对快速获得护理的能力评分明显低于白人患者(63.5(SE 3.38)vs.71.4(SE 2.12),p<0.01),任何其他种族/族裔的患者评分也较低(LS 均值 66.2(SE 2.89),p=0.02)。任何其他种族/族裔的患者报告其获得所需护理的能力明显低于白人患者(LS 均值 81.9(SE 2.46)vs.86.7(SE 1.75),p=0.02);然而,黑人和白人患者在获得所需护理的能力方面没有差异。

结论

非白人患者对快速获得护理的评分较低,表明在护理及时性方面存在种族差异。

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