通过实践设置和服务的患者对美国瘤学家农村的比较
Sarah L Cornelius1, Andrew P Shaefer2, Sandra L Wong2,3
1Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
JAMA network open
|January 5, 2024
概括
一种新方法将瘤科医生按患者的农村地区分类,发现服务于农村癌症患者的医生比传统的实践位置方法更多. 这种方法更好地反映了真正的农村瘤学工作人员.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 农村卫生 农村卫生
背景情况:
- 瘤学工作人员通常根据实践地点进行分类,可能低估了参与农村癌症护理的医生.
- 准确识别农村瘤学家对于了解和改善服务不足地区的癌症护理提供至关重要.
研究的目的:
- 为了比较一种新的方法来识别参与农村癌症护理的瘤医生,基于农村患者的比例,与实践位置的标准方法进行比较.
- 评估基于患者组的分类对农村瘤学工作人员的准确性和影响力.
主要方法:
- 这项横截面研究分析了医疗保险和医疗补助服务中心 (CMS) 对医疗瘤学家,放射瘤学家和外科医生治疗2019年患有乳腺癌,结肠直肠癌或肺癌的医疗保险受益者的回顾性数据.
- 医生农村被分类使用标准实践位置方法和基于其实践小组中农村患者百分比的新方法.
主要成果:
- 这项研究包括27,870名瘤医生;只有3.0%的医生在农村地区执业.
- 根据患者小组进行分类,发现参与农村癌症护理的医生数量显著增加:18.4%至少有20%的农村患者,11.5%至少有33%,7.2%至少有50%.
- 与实践位置方法相比,患者小组方法发现了更多的农村瘤医生和更广泛的分布,表现良好 (AUC,0.857) 和相对一致 (κ,0.346).
结论:
- 根据服务的农村患者的比例对瘤学家农村的分类,比传统的实践位置方法更能确定治疗农村人口的医生.
- 这种患者小组方法可能更准确地代表了农村癌症医生的劳动力,特别是考虑到城市医院的位置.
- 这种新的方法可以加强未来关于农村癌症护理和劳动力评估的研究.
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