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Variation in geographic access to chemotherapy by definitions of providers and service locations: a population-based observational study

Overview of attention for article published in BMC Health Services Research, July 2016
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Title
Variation in geographic access to chemotherapy by definitions of providers and service locations: a population-based observational study
Published in
BMC Health Services Research, July 2016
DOI 10.1186/s12913-016-1549-5
Pubmed ID
Authors

Mary C. Schroeder, Cole G. Chapman, Matthew C. Nattinger, Thorvardur R. Halfdanarson, Taher Abu-Hejleh, Yu-Yu Tien, John M. Brooks

Abstract

An aging population, with its associated rise in cancer incidence and strain on the oncology workforce, will continue to motivate patients, healthcare providers and policy makers to better understand the existing and growing challenges of access to chemotherapy. Administrative data, and SEER-Medicare data in particular, have been used to assess patterns of healthcare utilization because of its rich information regarding patients, their treatments, and their providers. To create measures of geographic access to chemotherapy, patients and oncologists must first be identified. Others have noted that identifying chemotherapy providers from Medicare claims is not always straightforward, as providers may report multiple or incorrect specialties and/or practice in multiple locations. Although previous studies have found that specialty codes alone fail to identify all oncologists, none have assessed whether various methods of identifying chemotherapy providers and their locations affect estimates of geographic access to care. SEER-Medicare data was used to identify patients, physicians, and chemotherapy use in this population-based observational study. We compared two measures of geographic access to chemotherapy, local area density and distance to nearest provider, across two definitions of chemotherapy provider (identified by specialty codes or billing codes) and two definitions of chemotherapy service location (where chemotherapy services were proven to be or possibly available) using descriptive statistics. Access measures were mapped for three representative registries. In our sample, 57.2 % of physicians who submitted chemotherapy claims reported a specialty of hematology/oncology or medical oncology. These physicians were associated with 91.0 % of the chemotherapy claims. When providers were identified through billing codes instead of specialty codes, an additional 50.0 % of beneficiaries (from 23.8 % to 35.7 %) resided in the same ZIP code as a chemotherapy provider. Beneficiaries were also 1.3 times closer to a provider, in terms of driving time. Our access measures did not differ significantly across definitions of service location. Measures of geographic access to care were sensitive to definitions of chemotherapy providers; far more providers were identified through billing codes than specialty codes. They were not sensitive to definitions of service locations, as providers, regardless of how they are identified, generally provided chemotherapy at each of their practice locations.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 16 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 16 100%

Demographic breakdown

Readers by professional status Count As %
Other 3 19%
Student > Doctoral Student 3 19%
Student > Ph. D. Student 3 19%
Professor 2 13%
Student > Master 1 6%
Other 2 13%
Unknown 2 13%
Readers by discipline Count As %
Medicine and Dentistry 5 31%
Nursing and Health Professions 1 6%
Mathematics 1 6%
Pharmacology, Toxicology and Pharmaceutical Science 1 6%
Economics, Econometrics and Finance 1 6%
Other 2 13%
Unknown 5 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 September 2016.
All research outputs
#6,385,408
of 8,414,405 outputs
Outputs from BMC Health Services Research
#2,578
of 3,136 outputs
Outputs of similar age
#178,474
of 253,737 outputs
Outputs of similar age from BMC Health Services Research
#155
of 178 outputs
Altmetric has tracked 8,414,405 research outputs across all sources so far. This one is in the 13th percentile – i.e., 13% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,136 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.5. This one is in the 7th percentile – i.e., 7% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 253,737 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 17th percentile – i.e., 17% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 178 others from the same source and published within six weeks on either side of this one. This one is in the 7th percentile – i.e., 7% of its contemporaries scored the same or lower than it.