Quality of prostate cancer care among rural men in the Veterans Health Administration.

Abstract

BACKGROUND Patient travel distances, coupled with variation in facility-level resources, create barriers for prostate cancer care in the Veterans Health Administration integrated delivery system. For these reasons, the authors investigated the degree to which these barriers impact the quality of prostate cancer care. METHODS The Veterans Affairs Central Cancer Registry was used to identify all men who were diagnosed with prostate cancer in 2008. Patient residence was characterized using Rural Urban Commuting Area codes. The authors then examined whether rural residence, compared with urban residence, was associated with less access to cancer-related resources and worse quality of care for 5 prostate cancer quality measures. RESULTS Approximately 25% of the 11,368 patients who were diagnosed with prostate cancer in 2008 lived in either a rural area or a large town. Rural patients tended to be white (62% urban vs 86% rural) and married (47% urban vs 63% rural), and they tended to have slightly higher incomes (all P<.01) but similar tumor grade (P=.23) and stage (P=.12) compared with urban patients. Rural patients were significantly less likely to be treated at facilities with comprehensive cancer resources, although they received a similar or better quality of care for 4 of the 5 prostate cancer quality measures. The time to prostate cancer treatment was similar (rural patients vs urban patients, 96.6 days vs 105.7 days). CONCLUSIONS Rural patients with prostate cancer had less access to comprehensive oncology resources, although they received a similar quality of care, compared with their urban counterparts in the Veterans Health Administration integrated delivery system. A better understanding of the degree to which facility factors contribute to the quality of cancer care may assist other organizations involved in rural health care delivery.

DOI: 10.1002/cncr.28275
01002002014201520162017
Citations per Year

236 Citations

Semantic Scholar estimates that this publication has 236 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Skolarus2013QualityOP, title={Quality of prostate cancer care among rural men in the Veterans Health Administration.}, author={Ted A. Skolarus and Stephanie W. C. Chan and Jeremy B. Shelton and Anna Liza Malazarte Antonio and Anne Sales and Jennifer L. Malin and Christopher S. Saigal}, journal={Cancer}, year={2013}, volume={119 20}, pages={3629-35} }