Details

Autor(en) / Beteiligte

• Roth, Lindsey M
• Tirodkar, Manasi
• Patel, Tejal
• Friedberg, Mark
• Smith-McLallen, Aaron
• Scholle, Sarah Hudson

Titel

Patient-centered oncology care: impact on utilization, patient experiences, and quality

Ist Teil von

• The American journal of managed care, 2020-09, Vol.26 (9), p.372-380

Ort / Verlag

Jamesburg: MultiMedia Healthcare Inc

Erscheinungsjahr

2020

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Objectives: To determine whether implementation of patient-centered oncology standards in 5 medical oncology practices improved patient experiences and quality and reduced emergency department (ED) and hospital use. Study Design: Retrospective, pre-post study design with a concurrent nonrandomized control group. Methods: We used insurance claims to calculate all-cause hospitalizations and ED visits and primary care and specialist office visits (n = 28,826 eligible patients during baseline and 30,843 during follow-up) and identify patients for a care experiences survey (n = 715 preintervention and 437 postintervention respondents). For utilization and patient experience outcomes, we compared pilot practices' performance with 18 comparison practices using difference-in-differences (DID) regression models accounting for practice-level clustering. We assessed pilot practice performance on 31 quality measures from the American Society of Clinical Oncology Quality Oncology Practice Initiative program. Results: There were no statistically significant differences in hospital, ED, or primary care visits between the pilot and comparison groups over time, but there was a significant increase in specialty visits for the pilot group (adjusted DID of 0.07; 95% CI, 0.01-0.13; P = .03). For care experiences, pilot practices improved more on shared decision-making (4.03 DID composite score; P = .013), whereas the comparison group improved more on access (–6.36 DID composite score; P < .001) and exchanging information (–4.25 DID composite score; P = .013). On average, pilot practices improved performance on 65% of core quality measures from baseline to follow-up. Conclusions: This pilot of patient-centered oncology care showed improved quality but no impact on hospitalizations/ED use and mixed results for patient experiences. Findings are consistent with early evaluations of primary care patient-centered medical homes.