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dc.contributor.authorHo, Vivian
Ku-Goto, Meei-Hsiang
Zhao, Hui
Hoffman, Karen E
Smith, Benjamin D
Giordano, Sharon H
dc.date.accessioned 2016-08-11T13:55:05Z
dc.date.available 2016-08-11T13:55:05Z
dc.date.issued 2016
dc.identifier.citation Ho, Vivian, Ku-Goto, Meei-Hsiang, Zhao, Hui, et al.. "Regional differences in recommended cancer treatment for the elderly." BMC Health Services Research, 16, (2016) BioMed Central: http://dx.doi.org/10.1186/s12913-016-1534-z.
dc.identifier.urihttps://hdl.handle.net/1911/91219
dc.description.abstract Abstract Background Little is known about regional variation in cancer treatment and its determinants. We compare rates of adherence to treatment guidelines for elderly patients across Texas and whether local specialist supply is an important determinant of treatment variation. Methods Previous literature reviewed indicated 7 recommended courses of treatment for colorectal, pancreatic, and prostate cancer. We analyzed Texas Cancer Registry data linked with Medicare claims for the years 2004 to 2007 to study patients with these cancers. We tested for unadjusted and adjusted differences in treatment rates across 22 hospital referral regions (HRR). We tested whether variation in the local supply of specialists treating each cancer was an important determinant of treatment. Results We found significant differences in adjusted treatment rates across regions. For removal and examination of 12+ lymph nodes with colon cancer resection, 13 of 22 HRRs had rates significantly different from the median region. For adjuvant chemotherapy for regional colon cancer, five HRRs significantly differed from the median. For prostate cancer treatment with a favorable diagnosis, nine HRRs differed from the median HRR. Of the 7 treatments, only the local availability of surgeons was an important determinant for excision of lymph nodes for colon cancer patients. Conclusions There are significant variations across Texas for seven recommended cancer treatments. No one region has consistently higher or lower treatments than other regions, and local specialist supply is not an important predictor of treatment. Different factors may be determining regional variation in treatment rates across cancer types and treatment options.
dc.publisher BioMed Central
dc.rightsThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.title Regional differences in recommended cancer treatment for the elderly
dc.type Journal article
dc.citation.journalTitle BMC Health Services Research
dc.citation.volumeNumber 16
dc.date.updated 2016-08-11T13:55:05Z
dc.type.dcmi Text
dc.identifier.doihttp://dx.doi.org/10.1186/s12913-016-1534-z
dc.language.rfc3066 en
dc.type.publication publisher version
dcterms.bibliographicCitation BMC Health Services Research. 2016 Jul 15;16(1):262
dc.rights.holder The Author(s).
local.sword.agent BioMed Central
dc.citation.articleNumber 262


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This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Except where otherwise noted, this item's license is described as This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.