Online Program

Survival disparity among non-small cell lung cancer patients: Can adherence to quality indicators reduce the socioeconomic differences?

Tuesday, November 5, 2013 : 8:30 a.m. - 8:45 a.m.

Yun-Yi Chen, College of Public Health, National Taiwan University, Taipei, Taiwan
Kuo-Piao Chung, PhD, Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan, Taipei City, Taiwan
Background: Concern has been raised over the disproportionate mortality among cancer patients with low socioeconomic status. However, physician adherence to evidence has been shown to improve outcomes. We sought to explore whether of 100% adherence to a set of quality indicators with non-small cell lung cancer is associated with better survival, even among socially vulnerable groups. Method: We carried out a retrospective cohort study in the national health insurance database, combined with cancer registry data and death registry. A set of quality indicators applied to individuals with non-small cell lung cancer were used to measure the quality of care in 24,091 lung cancer patients newly diagnosed from 2004 to 2007. The main analysis of adherence was dichotomous as 100% adherence or not. Data was analyzed using Cox proportional-hazards regression model, controlling for the characteristics of patients and the characteristics of healthcare providers. Result: Most patients (79.8%) received care with complete adherence to the quality indicators. Multivariate analysis revealed that 100% adherence was associated with better overall survival (HR: 0.54, CI: 0.52-0.56). Although patient with lower income or unemployment were at high risk of mortality, 100% adherence to quality indicators significantly moderate the relationship between socioeconomic factors and conditions of survival. Conclusion: Although socioeconomic differences of survival exist in non-small cell lung cancer, complete adherence to quality indicators may narrow the disparity.

Learning Areas:

Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Identify the influence of socioeconomic factors on survival in non-small cell lung cancer patients. Examine the impact of adherence to quality indicators on the relationship between socioeconomic factors and survival.

Keyword(s): Adherence, Quality of Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-author of this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.