Integrated care among patients with kidney or urinary bladder cancer: An NCI patterns-of-care analysis

Area of Science:

• Oncology
• Health Services Research
• Cancer Care Delivery

Background:

• Integrated care, encompassing care coordination and supportive services, is essential for optimal cancer patient management.
• Understanding factors influencing integrated care receipt is critical for improving patient outcomes.
• This study focuses on kidney and urinary bladder cancer patients to identify disparities in integrated care access.

Purpose of the Study:

• To describe patterns of integrated care utilization in kidney and urinary bladder cancer patients.
• To examine patient-level and hospital-level factors associated with receiving integrated care services.
• To identify potential disparities in access to integrated cancer care.

Main Methods:

• Analysis of 2019 National Cancer Institute Patterns-of-Care data.
• Inclusion of stage I-IV kidney and stage 0a-IVb urinary bladder cancer patients (≥20 years).
• Medical record abstraction to identify integrated care services within 12 months postdiagnosis; multivariable logistic regression used.

Main Results:

• Integrated care receipt varied significantly by insurance status, with uninsured patients less likely to receive services.
• Non-Hispanic white patients were more likely to receive integrated care compared to other racial/ethnic groups.
• Stage IV kidney cancer patients had higher odds of receiving integrated care than Stage I; treatment and hospital factors had minimal impact.

Conclusions:

• Disparities in integrated care access exist for uninsured and certain racial/ethnic groups, indicating inequities in patient-centered cancer care.
• Addressing these gaps is crucial for achieving equitable cancer care delivery.
• Future research should incorporate patient perspectives to better understand unmet needs and influencing factors.