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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 11 of 11 Research Studies DisplayedReed KG, Sun Z, Yabes JG
Assessing characteristics of populations seen at Commission on Cancer facilities using Pennsylvania linked data.
The purpose of this study was to evaluate variations among patients who do and do not visit Commission on Cancer (CoC) accredited facilities. The researchers utilized Pennsylvania Cancer Registry data linked to facility records for 87,472 patients diagnosed with cancer between 2018 and 2019. The study found that patients in the most advantaged Area Deprivation Index quartiles were more likely to visit CoC facilities compared with other quartiles. Urban patients were more likely than rural to be seen at a CoC facility as were Hispanic patients and non-Hispanic Black patients compared with White patients.
AHRQ-funded; HS027396.
Citation: Reed KG, Sun Z, Yabes JG .
Assessing characteristics of populations seen at Commission on Cancer facilities using Pennsylvania linked data.
JNCI Cancer Spectr 2023 Oct 31; 7(6). doi: 10.1093/jncics/pkad080..
Keywords: Cancer, Health Information Technology (HIT), Racial and Ethnic Minorities, Rural Health, Rural/Inner-City Residents
Logan CD, Feinglass J, Halverson AL
Rural-urban disparities in receipt of surgery for potentially resectable non-small cell lung cancer.
This study examined the reasons there are lower rates of surgical treatment for potentially resectable non-small cell lung cancer (NSCLC) for patients living in rural areas than in urban areas. The National Cancer Database was used to identify patients with clinical stage I-IIIA NSCLC between 2004 and 2018. Reasons for nonreceipt of surgery was evaluated for rural and urban area patients. The study included 328,785 patients with NSCLC with 13% from rural areas. Overall, 62.4% of patients from urban areas and 58.8% of patients from rural areas underwent surgery. Patients from rural areas had increased odds of (1) being recommended primary nonsurgical management, (2) surgery being deemed contraindicated due to risk, (3) surgery being recommended but not performed, and (4) overall failure to receive surgery.
AHRQ-funded; HS026385.
Citation: Logan CD, Feinglass J, Halverson AL .
Rural-urban disparities in receipt of surgery for potentially resectable non-small cell lung cancer.
J Surg Res 2023 Mar;283:1053-63. doi: 10.1016/j.jss.2022.10.097.
Keywords: Cancer: Lung Cancer, Cancer, Disparities, Surgery, Rural Health, Access to Care
Herb J, Holmes M, Stitzenberg K
Trends in rural-urban disparities among surgical specialties treating cancer, 2004-2017.
The purpose of this study was to assess trends over time in rural and urban disparities in the supply of surgeons treating patients with cancer. The researchers utilized the Area Health Resource File to conduct a retrospective observational study of medical workforce changes from 2004-2017. The study found that the density of surgical specialists in rural areas declined from 16 to 14 per 100,000 population and in urban areas from 33 to 31 per 100,000 population for a rural-urban disparity increase of 8%. The percentage increase in the supply disparity between the rural and urban workforce was largest for colorectal surgeons (66%) and general surgeons (72%). The study concluded that temporal changes in the rural-urban physician workforce depend on community factors, region, and area of specialization.
AHRQ-funded; HS000032.
Citation: Herb J, Holmes M, Stitzenberg K .
Trends in rural-urban disparities among surgical specialties treating cancer, 2004-2017.
J Rural Health 2022 Sep;38(4):838-44. doi: 10.1111/jrh.12658..
Keywords: Rural Health, Disabilities, Surgery, Cancer, Workforce
Roberson ML, Nichols HB, Olshan AF
Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality.
The authors sought to examine trends in the surgical treatment of breast cancer by age, rurality, and among Black women in a populous, racially diverse, state in the Southeastern United States of America. Using data from the North Carolina Central Cancer Registry, they found declining mastectomy rates in the early 2000s in a Southern US state with a racially and geographically diverse population. These decreasing trends were consistent among key subgroups affected by cancer inequities, including Black and White rural women.
AHRQ-funded; HS027299.
Citation: Roberson ML, Nichols HB, Olshan AF .
Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality.
Breast Cancer Res Treat 2022 Jun;193(2):445-54. doi: 10.1007/s10549-022-06564-w..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery, Racial and Ethnic Minorities, Rural Health
Herb J, Wolff R, McDaniel P
Rural representation of the surveillance, epidemiology, and end results database.
The purpose of this study was to assess how well the rural areas covered by SEER represent the broader rural United States for cancer care. Findings showed that the rural population covered by SEER data is comparable to the rural population in non-SEER areas. However, patients in rural SEER regions have shorter travel times to care than rural patients in non-SEER regions, which should be considered when using SEER-Medicare to study access to cancer care.
AHRQ-funded; HS000032.
Citation: Herb J, Wolff R, McDaniel P .
Rural representation of the surveillance, epidemiology, and end results database.
Cancer Causes Control 2021 Mar;32(3):211-20. doi: 10.1007/s10552-020-01375-0..
Keywords: Cancer, Rural Health
Herb JN, Wolff RT, McDaniel PM
Travel time to radiation oncology facilities in the United States and the influence of Certificate of Need Policies.
The authors’ goal was to evaluate travel times to US radiation oncology (RO) facilities and to assess the association with Certificate of Need (CON) policies. RO facilities were identified from the 2018 National Plan and Provider Enumeration System. They found that isolated rural US census tracts, accounting for 9.4 million Americans, have nearly 1-hour longer adjusted travel time to the nearest RO facility, compared with urban tracts. CON laws had region-dependent associations with prolonged travel.
AHRQ-funded; HS000032.
Citation: Herb JN, Wolff RT, McDaniel PM .
Travel time to radiation oncology facilities in the United States and the influence of Certificate of Need Policies.
International Journal of Radiation Oncology, Biology, Physics 2021 Feb;109(2):344-51. doi: 10.1016/j.ijrobp.2020.08.059..
Keywords: Cancer, Rural Health, Access to Care, Policy
Herb JN, Dunham LN, Mody G
Lung cancer surgical regionalization disproportionately worsens travel distance for rural patients.
Researchers hypothesized that lung cancer patients have been traveling further for surgery over time as regionalization has occurred, and this increased travel has primarily impacted rural patients. Using data from a North Carolina all-payer state discharge database, they found that the number of hospitals performing lung cancer resections decreased from 49 to 31 over the study period, and the proportion of patients receiving care at high-volume centers increased. Rural patient travel distance increased over time by 8.5 miles, with no change in urban patient travel distance. They concluded that, in North Carolina, lung cancer surgical regionalization occurred over the study period and was accompanied by increases in travel distance for rural patients only. They recommended further work to determine the effects of greater travel distance on patterns of cancer care for rural patients.
AHRQ-funded; HS000032.
Citation: Herb JN, Dunham LN, Mody G .
Lung cancer surgical regionalization disproportionately worsens travel distance for rural patients.
J Rural Health 2020 Sep;36(4):496-505. doi: 10.1111/jrh.12440..
Keywords: Cancer: Lung Cancer, Cancer, Rural Health, Surgery, Access to Care
Longacre CF, Neprash HT, Shippee ND
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
This study characterizes the actual distance older breast cancer patients traveled to radiation treatment and the minimum distance necessary to reach radiation care, and examines whether any patient demographic or clinical factors are associated with greater travel distance. Findings showed that patients living in rural areas traveled on average nearly 3 times as far as those from urban areas, and their nearest facility was more than 4 times farther away. Older age, being single or widowed, and lower household income were significantly associated with shorter actual travel distance, while increasing rurality was significantly associated with greater actual and minimum travel distance to radiation treatment.
AHRQ-funded; HS026660.
Citation: Longacre CF, Neprash HT, Shippee ND .
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
J Rural Health 2020 Jun;36(3):334-46. doi: 10.1111/jrh.12413..
Keywords: Rural Health, Cancer: Breast Cancer, Cancer, Elderly, Women, Access to Care, Disparities
Spees LP, Brewster WR, Varia MA
Examining urban and rural differences in how distance to care influences the initiation and completion of treatment among insured cervical cancer patients.
Although rural cancer patients encounter substantial barriers to care, they more often report receiving timely care than urban patients. In this study, the investigators examined whether geographic distance, a contributor to urban-rural health disparities, differentially influenced treatment initiation and completion among insured urban and rural cervical cancer patients. The investigators found that geographic distance differentially influenced the initiation and completion of treatment among urban and rural cervical cancer patients.
AHRQ-funded; HS000032.
Citation: Spees LP, Brewster WR, Varia MA .
Examining urban and rural differences in how distance to care influences the initiation and completion of treatment among insured cervical cancer patients.
Cancer Epidemiol Biomarkers Prev 2019 May;28(5):882-89. doi: 10.1158/1055-9965.Epi-18-0945..
Keywords: Rural Health, Urban Health, Disparities, Access to Care, Cancer: Cervical Cancer, Cancer
Lee SC, Higashi RT, Sanders JM
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Effects of geographic program expansion to rural areas on mammogram screening program outcomes are understudied. The authors of this study sought to determine whether time-to-resolution (TTR) varied significantly by service delivery time period, location, and participant characteristics across 19 North Texas counties.
AHRQ-funded; HS022418.
Citation: Lee SC, Higashi RT, Sanders JM .
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Cancer Causes Control 2018 Oct;29(10):995-1005. doi: 10.1007/s10552-018-1074-4..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women, Rural Health, Access to Care, Prevention
Horner-Johnson W, Dobbertin K, Iezzoni LI
Disparities in receipt of breast and cervical cancer screening for rural women age 18 to 64 with disabilities.
The authors examined the combination of disability status and rurality in association with receipt of breast and cervical cancer screening among women age 18 to 64 in the United States. They found that women with disabilities were less likely to be up to date with mammograms and Pap tests compared with women with no disabilities, and women in rural areas were less likely to have received breast or cervical cancer screening within recommended timeframes. Women with a disability who lived in a rural area were the least likely to be current with screening.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Dobbertin K, Iezzoni LI .
Disparities in receipt of breast and cervical cancer screening for rural women age 18 to 64 with disabilities.
Womens Health Issues 2015 May-Jun;25(3):246-53. doi: 10.1016/j.whi.2015.02.004.
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Keywords: Cancer, Disabilities, Medical Expenditure Panel Survey (MEPS), Rural Health, Screening