National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- (-) Cancer (13)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (2)
- Caregiving (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Data (1)
- Diagnostic Safety and Quality (1)
- Medicare (1)
- Medication (1)
- Men's Health (1)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient and Family Engagement (1)
- Practice Patterns (2)
- Primary Care (1)
- Provider (3)
- (-) Provider: Physician (13)
- Quality of Life (1)
- Shared Decision Making (1)
- Surgery (4)
- Vulnerable Populations (1)
- Workforce (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedNguyen CA, Beaulieu ND, Wright AA
Organization of cancer specialists in US physician practices and health systems.
This study’s objective was to describe the supply of cancer specialists, the organization of cancer care within versus outside of health systems, and the distance to multispecialty cancer centers. The authors used the 2018 Health Systems and Provider Database from the National Bureau of Economic Research and 2018 Medicare data to identify 46,341 unique physicians providing cancer care. They stratified physicians by discipline (adult/pediatric medical oncologists, radiation oncologists, surgical/gynecologic oncologists, other surgeons performing cancer surgeries, or palliative care physicians), system type (National Cancer Institute [NCI] Cancer Center system, non-NCI academic system, nonacademic system, or nonsystem/independent practice), practice size, and composition (single disciplinary oncology, multidisciplinary oncology, or multispecialty). They computed the density of cancer specialists by county and calculated distances to the nearest NCI Cancer Center. Results found that more than half of all cancer specialists (57.8%) practiced in health systems, but 55.0% of cancer-related visits occurred in independent practices. A majority of system-based physicians were in large practices with more than 100 physicians, while those in independent practices were in smaller practices. Breakdown by specialty type showed that practices in NCI Cancer Center systems (95.2%), non-NCI academic systems (95.0%), and nonacademic systems (94.3%) were primarily multispecialty, while fewer independent practices (44.8%) were. Many rural areas had sparse cancer specialty density, where the median travel distance to an NCI Cancer Center was 98.7 miles. Higher-income areas had shorter distances to NCI Cancer centers than low-income areas, even for individuals in suburban and rural areas.
AHRQ-funded; HS024072.
Citation: Nguyen CA, Beaulieu ND, Wright AA .
Organization of cancer specialists in US physician practices and health systems.
J Clin Oncol 2023 Sep 10; 41(26):4226-35. doi: 10.1200/jco.23.00626..
Keywords: Cancer, Provider: Physician, Workforce
Rao G, Ufholz K, Saroufim P
Recognition, diagnostic practices, and cancer outcomes among patients with unintentional weight loss (UWL) in primary care.
The objective of this study was to identify the incidence, rate of physician recognition, diagnostic practices, and cancer outcomes for unintentional weight loss. Researchers completed a secondary analysis of structured and unstructured EHR data collected from adult, established primary care patients with a minimum of two weight measurements in 2020 and in 2021. The results indicated that unintentional weight loss is poorly recognized across a diverse range of patients. The researchers concluded that lack of research-informed guidance may explain low rates of recognition and variability in diagnostic practices.
AHRQ-funded; HS029358.
Citation: Rao G, Ufholz K, Saroufim P .
Recognition, diagnostic practices, and cancer outcomes among patients with unintentional weight loss (UWL) in primary care.
Diagnosis 2023 Aug 1; 10(3):267-74. doi: 10.1515/dx-2023-0002..
Keywords: Cancer, Primary Care, Diagnostic Safety and Quality, Provider: Physician
Hu FY, Tabata-Kelly M, Johnston FM
Surgeon-reported factors influencing adoption of quality standards for goal-concordant care in patients with advanced cancer: a qualitative study.
This study’s objective was to explore surgical oncologists' perspectives on factors influencing adoption of quality standards in patients with advanced cancer. While the American College of Surgeons has adopted a Geriatric Surgery Verification Program that includes communication standards designed to facilitate goal-concordant care, little is known about how surgeons believe these standards align with clinical practice. The authors conducted semistructured video-based interviews from November 2020 to January 2021 with academic surgical oncologists purposively sampled based on demographics, region, palliative care certification, and years in practice. These interviews addressed: (1) adherence to standards documenting care preferences for life-sustaining treatment, surrogate decision-maker, and goals of surgery; and (2) factors influencing their adoption into practice. Participants included 26 surgeons (57.7% male, 8.5 mean years in practice, 19.2% palliative care board-certified). While goals of surgery are commonly discussed, there is low consistency of documenting these goals. There were conflicting views about the relevance of care preferences to preoperative conversations and surrogate decision-maker documentation by the surgeon and questioned the direct connection between documentation of quality standards and higher value patient care. Key themes in adopting quality standards of documentation included organizational culture, workflow, and multidisciplinary collaboration.
AHRQ-funded; HS024736.
Citation: Hu FY, Tabata-Kelly M, Johnston FM .
Surgeon-reported factors influencing adoption of quality standards for goal-concordant care in patients with advanced cancer: a qualitative study.
Ann Surg 2023 May; 277(5):e1000-e05. doi: 10.1097/sla.0000000000005441..
Keywords: Surgery, Provider: Physician, Cancer
Mitchell JM, Gresenz CR
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Researchers examined the influence of type of practice structure, and by implication the financial incentives associated with each structure, on treatment received among men newly diagnosed with low-risk prostate cancer. They found that physician practice structure attributes were significantly associated with type of treatment received but few studies controlled for such factors. Their findings - coupled with the observation that urologist practice structure shifted substantially over this time period due to mergers of small urology groups - provided one explanation for the limited uptake of active surveillance among men with low-risk disease in the US.
AHRQ-funded; HS024972.
Citation: Mitchell JM, Gresenz CR .
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Med Care 2022 Sep;60(9):665-72. doi: 10.1097/mlr.0000000000001746..
Keywords: Cancer: Prostate Cancer, Cancer, Practice Patterns, Men's Health, Provider: Physician
Hughes DT, Reyes-Gastelum D, Ward KC DT, Reyes-Gastelum D, Ward KC
Barriers to the use of active surveillance for thyroid cancer results of a physician survey.
This study’s aim was to determine physician-reported use of and barriers to active surveillance for thyroid cancer. Surgeons and endocrinologists who were identified by thyroid cancer patients from the SEER registries of Georgia and Los Angeles County were surveyed between 2018 and 2019. Of the 654 eligible physicians identified, 448 responded to the survey. The majority (76%) believed that active surveillance was an appropriate management option, but only 44% provided that surveillance. Physicians who stated that active surveillance was appropriate management but did not use it tended to have more years in practice (>10 years) and higher patient volume (11-30 patients per year or >50 patients per year) compared to doctors with less than 10 years in practice, with no significant difference in seeing 31 to 50 patients. Barriers reported to active surveillance included patients that did not want it (80.3%), loss to follow-up concern (78.4%), more patient worry (57.6%), and malpractice lawsuit concern (50.9%).
AHRQ-funded; HS024512.
Citation: Hughes DT, Reyes-Gastelum D, Ward KC DT, Reyes-Gastelum D, Ward KC .
Barriers to the use of active surveillance for thyroid cancer results of a physician survey.
Ann Surg 2022 Jul 1;276(1):e40-e47. doi: 10.1097/sla.0000000000004417..
Keywords: Cancer, Provider: Physician
Mitchell JM, Gresenz CR
Documenting horizontal integration among urologists who treat prostate cancer.
The purpose of this study was to create and employ a methodology to document changes in physician practice structure resulting from horizontal mergers among urology groups. To identify all urologists who treated men with prostate cancer, the researchers integrated cancer registry records from four large states with Medicare Part B claims. Information from SK & A surveys and extensive internet searches was added to assign a practice structure to each urologist-year from 2005-2014. The study found that horizontal merging among small urology groups resulted in a strong increase in the percentage of urologists who belong to large urology practices with ownership in anatomical pathology services and/or intensity modulated radiation therapy. By 2014, small percentages (7%-16%) of New Jersey, Florida and Texas urologists were employed by a health system, whereas more than half of New Jersey urologists and about 43% of urologists in Florida and Texas were members of large practices. This is compared to California urologists of which only 17.5% had ownership in intensity modulated radiation therapy and/or pathology services. The researchers highlighted that the study indicators of market share of urologists connected with each practice structure type were highly correlated with indicators of market share based on quantity of prostate cancer events treated by each type of practice structure.
AHRQ-funded; HS024972.
Citation: Mitchell JM, Gresenz CR .
Documenting horizontal integration among urologists who treat prostate cancer.
Med Care Res Rev 2022 Feb;79(1):141-50. doi: 10.1177/1077558720980552..
Keywords: Cancer: Prostate Cancer, Cancer, Provider: Physician
Rosko AJ, Gay BL, Reyes-Gastelum D
Surgeons' attitudes on total thyroidectomy vs lobectomy for management of papillary thyroid microcarcinoma.
The incidence of papillary thyroid cancer has increased in the past 25 years without a clear increase in thyroid cancer deaths. Given these findings, there has been a shift toward recommending conservative surgical options, with current management guidelines favoring lobectomy, especially for patients with papillary thyroid microcarcinoma. The aim of this study was to identify surgeons’ attitudes regarding surgical management of microcarcinomas with the hypothesis that surgeons consider other factors, in addition to tumor size, when selecting a surgical procedure.
AHRQ-funded; HS024512.
Citation: Rosko AJ, Gay BL, Reyes-Gastelum D .
Surgeons' attitudes on total thyroidectomy vs lobectomy for management of papillary thyroid microcarcinoma.
JAMA Otolaryngol Head Neck Surg 2021 Jul;147(7):667-69. doi: 10.1001/jamaoto.2021.0525..
Keywords: Cancer, Surgery, Practice Patterns, Provider: Physician
Papaleontiou M, Zebrack B, Reyes-Gastelum D
Physician management of thyroid cancer patients' worry.
This study’s purpose was to understand physician management of thyroid cancer-related worry. Endocrinologists, general surgeons, and otolaryngologists identified by Surveillance, Epidemiology, and End Results (SEER) patients were surveyed in 2018 to 2019. The response rate was 69% with 448 physicians responding. Physicians reported their patients as quite/very worried (65%), very worried (27%), and a little/not worried (8%) at diagnosis, with half telling their patients that thyroid cancer is a “good cancer”. Otolaryngologists, private practice, and West Coast (Los Angeles versus Georgia) were associated with using the term “good cancer”. Physician response to worries were good, with 97% of physicians making themselves available for discussion, 44% referring their patients to educational websites, 18% encouraging communication with family/friends, 13% referring their patients to support groups, and 7% referring them to counselors. Physicians who perceived their patients as being quite/very worried were less likely to use the term “good cancer” and more likely to encourage patients to seek help outside the physician-patient relationship.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Zebrack B, Reyes-Gastelum D .
Physician management of thyroid cancer patients' worry.
J Cancer Surviv 2021 Jun;15(3):418-26. doi: 10.1007/s11764-020-00937-0..
Keywords: Cancer, Provider: Physician, Provider
Sutter ME, Simmons VN, Sutton SK
Oncologists' experiences caring for LGBTQ patients with cancer: qualitative analysis of items on a national survey.
Sexual and gender minority (SGM) individuals experience cancer-related health disparities and reduced quality of cancer care compared to the general population in part due to a lack of knowledgeable providers. This study explored oncologists' experiences and perspectives in providing patient-centered care for SGM individuals with cancer. The investigators concluded that oncologists recognized their knowledge deficits and need strategies to overcome communication barriers and microaggressions among the cancer care team to provide SGM-affirming care.
AHRQ-funded; HS026120.
Citation: Sutter ME, Simmons VN, Sutton SK .
Oncologists' experiences caring for LGBTQ patients with cancer: qualitative analysis of items on a national survey.
Patient Educ Couns 2021 Apr;104(4):871-76. doi: 10.1016/j.pec.2020.09.022..
Keywords: Cancer, Provider: Physician, Vulnerable Populations
Johnston FM, Beckman M
Navigating difficult conversations.
In this paper, the authors discussed breaking bad news and navigating difficult conversations in surgical oncology practice. They note that mounting evidence supports a patient-centered communication approach and models of shared decisionmaking. Physician training in patient-centered cancer communication also continues to evolve.
AHRQ-funded; HS024736.
Citation: Johnston FM, Beckman M .
Navigating difficult conversations.
J Surg Oncol 2019 Jul;120(1):23-29. doi: 10.1002/jso.25472..
Keywords: Cancer, Clinician-Patient Communication, Communication, Shared Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Provider: Physician, Surgery
Mitchell AP, Winn AN, Lund JL
Evaluating the strength of the association between industry payments and prescribing practices in oncology.
Financial relationships between physicians and the pharmaceutical industry are common, but factors that may determine whether such relationships result in physician practice changes are unknown. This study evaluated physician use of orally administered cancer drugs for four cancers and whether practice setting at a National Cancer Institute (NCI)-designated Comprehensive Cancer Center, receipt of payments for purposes other than education or research (compensation payments), maximum annual dollar value received, and institutional conflict-of-interest policies were associated with the strength of the payment-prescribing association.
AHRQ-funded; HS000032.
Citation: Mitchell AP, Winn AN, Lund JL .
Evaluating the strength of the association between industry payments and prescribing practices in oncology.
Oncologist 2019 May;24(5):632-39. doi: 10.1634/theoncologist.2018-0423..
Keywords: Cancer, Medication, Provider: Physician, Provider
Tong BC, Kim S, Kosinski A
Penetration, completeness, and representativeness of the Society of Thoracic Surgeons General Thoracic Surgery Database for lobectomy.
Not all surgeons performing lobectomy in the United States report outcomes to The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD). In this study, the investigators examined penetration, completeness, and representativeness of the STS GTSD for lobectomy in the Centers for Medicare and Medicaid Services (CMS) patient population. The investigators concluded that participation in the STS GTSD increased over time, but penetration lagged behind that of the other STS National Databases.
AHRQ-funded; HS022279.
Citation: Tong BC, Kim S, Kosinski A .
Penetration, completeness, and representativeness of the Society of Thoracic Surgeons General Thoracic Surgery Database for lobectomy.
Ann Thorac Surg 2019 Mar;107(3):897-902. doi: 10.1016/j.athoracsur.2018.07.059..
Keywords: Surgery, Cancer: Lung Cancer, Cancer, Data, Provider: Physician, Provider
Rocke DJ, Beumer HW, Taylor DH, Jr.
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
The investigators sought to determine how baseline attitudes toward quality vs quantity of life affect end-of-life resource allocation. They found that, compared with patients and caregivers, otolaryngology-head and neck surgery (OHNS) physician allocations differed significantly in all 15 benefit categories except home care. They concluded that understanding the effect of baseline attitudes is important for effective end-of-life discussions.
AHRQ-funded; HS018360.
Citation: Rocke DJ, Beumer HW, Taylor DH, Jr. .
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
JAMA Otolaryngol Head Neck Surg 2014 Jun;140(6):497-503. doi: 10.1001/jamaoto.2014.494.
.
.
Keywords: Cancer, Caregiving, Medicare, Palliative Care, Provider: Physician, Quality of Life