Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, United States of America.
Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States of America.
J Geriatr Oncol. 2023 Jul;14(6):101554. doi: 10.1016/j.jgo.2023.101554. Epub 2023 Jun 13.
Our purpose was to evaluate whether racial/ethnic disparities in patient care experiences (PCEs) differ between males with prostate cancer ("PCa group") and males without cancer ("non-cancer group").
This retrospective study used 2007-2015 National Cancer Institute's Surveillance, Epidemiology and End Results registry data linked to Consumer Assessment of Healthcare Providers and Systems surveys. PCa and non-cancer groups were propensity score matched 1:5 on demographic and clinical characteristics. Differences in racial/ethnic disparities (DRD) (non-Hispanic Black [NHB], Hispanic, non-Hispanic Asian [NHA], and Other Races compared to non-Hispanic White [NHW]) in PCEs (getting needed care, getting care quickly, doctor communication, customer service, and getting needed prescription drugs) were compared between matched PCa and non-cancer groups. Per prior literature, DRD in PCE scores were categorized as small (<3), medium (≥3 but <5) or large (≥5).
There were 7312 males in the PCa group and 36,559 matched males in the non-cancer group. Within each group, all racial/ethnic minority categories reported worse scores compared to NHW individuals (p < 0.05) for ≥3 PCE composite measures. Compared to PCa group, a larger NHA-NHW difference was observed in non-cancer group for getting needed care (-4.65 in PCa vs. -7.77 in non-cancer; DRD = 3.11, p = 0.029) and doctor communication (-2.46 in PCa vs. -4.85 in non-cancer; DRD = 2.38, p = 0.023).
In both PCa and non-cancer groups, racial/ethnic minorities reported worse experiences compared to NHW individuals for several PCE measures. However, the difference in getting needed care and doctor communication between NHA and NHW individuals were more pronounced in non-cancer group than PCa group.
本研究旨在评估男性前列腺癌患者(“PCa 组”)与无癌症男性(“非癌症组”)的患者护理体验(PCE)的种族/民族差异是否存在差异。
本回顾性研究使用了 2007-2015 年国家癌症研究所的监测、流行病学和最终结果登记处的数据,并与医疗保健提供者和系统调查的消费者评估进行了关联。根据人口统计学和临床特征,对 PCa 组和非癌症组进行了倾向评分 1:5 匹配。比较了匹配的 PCa 组和非癌症组之间的 PCE(获得所需护理、快速获得护理、医生沟通、客户服务和获得所需处方药)的种族/民族差异(非西班牙裔黑人[NHB]、西班牙裔、非西班牙裔亚裔[NHA]和其他种族与非西班牙裔白人[NHW])。根据先前的文献,PCE 评分的种族/民族差异(DRD)分为小(<3)、中(≥3 但<5)或大(≥5)。
PCa 组有 7312 名男性,非癌症组有 36559 名匹配的男性。在每个组中,所有少数族裔群体与 NHW 个体相比,报告的 PCE 综合测量指标中,≥3 项得分较差(p<0.05)。与 PCa 组相比,在非癌症组中,NHA-NHW 在获得所需护理方面的差异更大(PCa 组为-4.65,非癌症组为-7.77;DRD=3.11,p=0.029)和医生沟通(PCa 组为-2.46,非癌症组为-4.85;DRD=2.38,p=0.023)。
在 PCa 组和非癌症组中,少数族裔群体在几项 PCE 测量指标中报告的体验均不如 NHW 个体。然而,在非癌症组中,NHA 和 NHW 个体之间在获得所需护理和医生沟通方面的差异比 PCa 组更为明显。