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Lung Cancer Mortality Racial/Ethnic Disparities in Patient Experiences with Care: a SEER-CAHPS Study

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Abstract

Background

To determine whether there are racial/ethnic disparities in patient experiences with care among lung cancer survivors, whether they are associated with mortality.

Methods

A retrospective cohort study of lung cancer survivors > 65 years old who completed a CAHPS survey > 6 months after the date of diagnosis. We used data from the SEER-Consumer Assessment of Healthcare Providers Systems (SEER-CAHPS®) database from 2000 to 2013 to assess racial/ethnic differences in patient experiences with care multivariable Cox proportional hazards models to assess the association between patient experience with care scores mortality in each racial/ethnic group.

Results

Within our cohort of 2603 lung cancer patients, Hispanic patients reported lower adjusted mean score with their ability to get needed care compared to white patients (B: − 5.21, 95% CI: − 9.03, − 1.39). Asian patients reported lower adjusted mean scores with their ability to get care quickly (− 4.25 (− 8.19, − 0.31)), get needed care (− 7.06 (− 10.51, − 3.61)), get needed drugs (− 9.06 (− 13.04, − 5.08)). For Hispanic patients, a 1-unit score increase in their ability to get all needed care (HR: 1.02, 1.00–1.03) care coordination (1.06, 1.02–1.09) was associated with higher risk of mortality. Among black patients, a 1-unit score increase in their ability to get needed care (HR: 0.99, 95% CI 0.98–0.99) care coordination (0.97, 0.94–0.99) was associated with lower risk mortality.

Conclusions

There are racial/ethnic disparities in lung cancer patient experiences with care that may impact mortality. Patient experiences with care are important risk factors of mortality for certain racial/ethnic groups.

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Acknowledgements

This study used the linked SEER-CAHPS data resource. The interpretation reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the National Cancer Institute; the Centers for Medicare & Medicaid Services; Information Management Services (IMS), Inc.; the Surveillance, Epidemiology, End Results (SEER) Program tumor registries in the creation of the SEER-CAHPS data resource.

Funding

This study was supported, in part, by a diversity research supplement from the National Cancer Institute (Grant No. R01CA209798-02S1, PI: AJF).

Author information

Authors and Affiliations

  1. Department of Population Public Health Sciences, Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA

    Albert J. Farias, Emily Chan, Stephanie Navarro & Myles Cockburn

  2. Gehr Family Center for Health System Science, Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA

    Albert J. Farias

  3. Department of Surgery, Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA

    Elizabeth A. David

  4. University of Colorado Anschutz Medical Campus, Aurora, USA

    Megan Eguchi

Authors
  1. Albert J. Farias
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  2. Emily Chan
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  3. Stephanie Navarro
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  4. Elizabeth A. David
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  5. Megan Eguchi
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  6. Myles Cockburn
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Contributions

Albert J. Farias: conceptualization, data curation, methodology, project administration, funding acquisition writing—original draft, review editing. Emily Chan: interpretation of results, writing—original draft, review editing. Stephanie Navarro: interpretation of results, writing—review editing. Elizabeth David: methodology, conceptualization, writing—review editing. Megan Eguchi: methodology, formal analysis, software, writing—review editing. Myles Cockburn: data curation, conceptualization, writing—review editing.

Corresponding author

Correspondence to Albert J. Farias.

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Ethics Approval

This is an observational study. The Institutional Review Board at the University of Southern California has confirmed that no ethical approval is required.

Competing Interests

The authors declare no competing interests.

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Farias, A.J., Chan, E., Navarro, S. et al. Lung Cancer Mortality Racial/Ethnic Disparities in Patient Experiences with Care: a SEER-CAHPS Study. J. Racial and Ethnic Health Disparities 10, 1745–1755 (2023). https://doi.org/10.1007/s40615-022-01358-8

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  • DOI: https://doi.org/10.1007/s40615-022-01358-8

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