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  1. Article: Geographic differences in community oncology provider and practice location characteristics in the central United States

    Ellis, Shellie D. / Thompson, Jeffrey A. / Boyd, Samuel S. / Roberts, Andrew W. / Charlton, Mary / Brooks, Joanna Veazey / Birken, Sarah A. / Wulff‐Burchfield, Elizabeth / Amponsah, Jonah / Petersen, Shariska / Kinney, Anita Y. / Ellerbeck, Edward

    Journal of rural health. 2022 Sept., v. 38, no. 4

    2022  

    Abstract: PURPOSE: How care delivery influences urban‐rural disparities in cancer outcomes is unclear. We sought to understand community oncologists’ practice settings to inform cancer care delivery interventions. METHODS: We conducted secondary analysis of a ... ...

    Abstract PURPOSE: How care delivery influences urban‐rural disparities in cancer outcomes is unclear. We sought to understand community oncologists’ practice settings to inform cancer care delivery interventions. METHODS: We conducted secondary analysis of a national dataset of providers billing Medicare from June 1, 2019 to May 31, 2020 in 13 states in the central United States. We used Kruskal‐Wallis rank and Fisher's exact tests to compare physician characteristics and practice settings among rural and urban community oncologists. FINDINGS: We identified 1,963 oncologists practicing in 1,492 community locations; 67.5% practiced in exclusively urban locations, 11.3% in exclusively rural locations, and 21.1% in both rural and urban locations. Rural‐only, urban‐only, and urban‐rural spanning oncologists practice in an average of 1.6, 2.4, and 5.1 different locations, respectively. A higher proportion of rural community sites were solo practices (11.7% vs 4.0%, P<.001) or single specialty practices (16.4% vs 9.4%, P<.001); and had less diversity in training environments (86.5% vs 67.8% with <2 medical schools represented, P<.001) than urban community sites. Rural multispecialty group sites were less likely to include other cancer specialists. CONCLUSIONS: We identified 2 potentially distinct styles of care delivery in rural communities, which may require distinct interventions: (1) innovation‐isolated rural oncologists, who are more likely to be solo providers, provide care at few locations, and practice with doctors with similar training experiences; and (2) urban‐rural spanning oncologists who provide care at a high number of locations and have potential to spread innovation, but may face high complexity and limited opportunity for care standardization.
    Keywords data collection ; rural communities ; rural health
    Language English
    Dates of publication 2022-09
    Size p. 865-875.
    Publishing place John Wiley & Sons, Ltd
    Document type Article
    Note JOURNAL ARTICLE
    ZDB-ID 639160-6
    ISSN 0890-765X
    ISSN 0890-765X
    DOI 10.1111/jrh.12663
    Database NAL-Catalogue (AGRICOLA)

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  2. Article ; Online: Geographic differences in community oncology provider and practice location characteristics in the central United States.

    Ellis, Shellie D / Thompson, Jeffrey A / Boyd, Samuel S / Roberts, Andrew W / Charlton, Mary / Brooks, Joanna Veazey / Birken, Sarah A / Wulff-Burchfield, Elizabeth / Amponsah, Jonah / Petersen, Shariska / Kinney, Anita Y / Ellerbeck, Edward

    The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association

    2022  Volume 38, Issue 4, Page(s) 865–875

    Abstract: Purpose: How care delivery influences urban-rural disparities in cancer outcomes is unclear. We sought to understand community oncologists' practice settings to inform cancer care delivery interventions.: Methods: We conducted secondary analysis of a ...

    Abstract Purpose: How care delivery influences urban-rural disparities in cancer outcomes is unclear. We sought to understand community oncologists' practice settings to inform cancer care delivery interventions.
    Methods: We conducted secondary analysis of a national dataset of providers billing Medicare from June 1, 2019 to May 31, 2020 in 13 states in the central United States. We used Kruskal-Wallis rank and Fisher's exact tests to compare physician characteristics and practice settings among rural and urban community oncologists.
    Findings: We identified 1,963 oncologists practicing in 1,492 community locations; 67.5% practiced in exclusively urban locations, 11.3% in exclusively rural locations, and 21.1% in both rural and urban locations. Rural-only, urban-only, and urban-rural spanning oncologists practice in an average of 1.6, 2.4, and 5.1 different locations, respectively. A higher proportion of rural community sites were solo practices (11.7% vs 4.0%, P<.001) or single specialty practices (16.4% vs 9.4%, P<.001); and had less diversity in training environments (86.5% vs 67.8% with <2 medical schools represented, P<.001) than urban community sites. Rural multispecialty group sites were less likely to include other cancer specialists.
    Conclusions: We identified 2 potentially distinct styles of care delivery in rural communities, which may require distinct interventions: (1) innovation-isolated rural oncologists, who are more likely to be solo providers, provide care at few locations, and practice with doctors with similar training experiences; and (2) urban-rural spanning oncologists who provide care at a high number of locations and have potential to spread innovation, but may face high complexity and limited opportunity for care standardization.
    MeSH term(s) Aged ; Humans ; Medicare ; Neoplasms/epidemiology ; Neoplasms/therapy ; Professional Practice Location ; Rural Population ; Specialization ; United States
    Language English
    Publishing date 2022-04-05
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 639160-6
    ISSN 1748-0361 ; 0890-765X
    ISSN (online) 1748-0361
    ISSN 0890-765X
    DOI 10.1111/jrh.12663
    Database MEDical Literature Analysis and Retrieval System OnLINE

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