How equitable is access to treatment for lung cancer patients? A population-based review of treatment practices in Ontario
| Autor: | Jennifer Stiff, Kyle Tsang, Aryn Gatto, Narges Nazen-Rad, Kelly J. Woltman, William K. Evans, Rebecca Anas, Carol Sawka, Sue Su-Myat, Yee C. Ung, Ashley Tyrrell, Phongsack Manivong, Gail Darling |
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| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Quality management business.industry Concordance Disease Guideline medicine.disease equity lung cancer 03 medical and health sciences 0302 clinical medicine Oncology 030220 oncology & carcinogenesis Health care medicine Residence 030212 general & internal medicine Rural area Lung cancer business Research Article access to treatment Demography |
| Zdroj: | Lung Cancer Management |
| ISSN: | 1758-1974 1758-1966 |
| DOI: | 10.2217/lmt-2017-0013 |
| Popis: | Aim: Guideline concordance is one of the metrics used by the Cancer Quality Council of Ontario and Cancer Care Ontario to assess the quality of cancer care and to drive quality improvement. Materials & Methods: The rates for lung cancer surgical resection and concordance with the Cancer Care Ontario postoperative adjuvant chemotherapy (AC) guideline were assessed by health region during two time periods (2010–2011 and 2012–2013) according to five equity measures (age, sex, neighborhood income, location of residence and size of immigrant population). Results: Of the patients with stage I/II NSCLC, 52.2% to 63.0% underwent surgical resection in the province of Ontario, Canada; for patients with stage IIIA disease, the rate was 26.4%. The probability of a surgical resection decreased substantially with age; only 26.9% of those with potentially resectable (stage I–IIIA) disease over 80 years underwent surgery. The use of postoperative AC increased modestly over the time of the study but the rate of use varied widely by health region (34.6 to 84.6%). Patients in rural areas were as likely to receive AC as urban dwellers; however, older aged patients (≥65 years) and those from the lowest income neighborhoods were significantly less likely to receive AC. Conclusion: Surgical rates and the use of AC vary by health region in Ontario and by age and level of neighborhood income despite universal access in a publicly funded health care system. The reasons for this variance are unclear but warrant further study. Presented in part at the 15th World Conference on Lung Cancer, Sydney, Australia, 27–30 October 2013 |
| Databáze: | OpenAIRE |
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