Abstract：
BACKGROUND: We sought to evaluate rural-urban disparities in patient care experiences (PCEs) among localized prostate cancer (PCa) survivors at intermediate-to-high risk of disease progression.
METHODS: Using 2007-2015 Surveillance Epidemiology and End Results (SEER) data linked to Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, we analyzed survivors\' first survey ≥6 months post-diagnosis. Covariate adjusted linear regressions were used to estimate associations of treatment status (definitive treatment vs. none) and residence (large metro vs. metro vs. rural) with PCE composite and rating measures.
RESULTS: Among 3779 PCa survivors, 1798 (53.2%) and 370 (10.9%) resided in large metro and rural areas, respectively; more rural (vs. large metro) residents were untreated (21.9% vs. 16.7%; p = 0.017). Untreated (vs. treated) PCa survivors reported lower scores for doctor communication (ß = -2.0; p = 0.022), specialist rating (ß = -2.5; p = 0.008), and overall care rating (ß = -2.4; p = 0.006). While treated rural survivors gave higher (ß = 3.6; p = 0.022) scores for obtaining needed care, untreated rural survivors gave lower scores for obtaining needed care (ß = -7.0; p = 0.017) and a lower health plan rating (ß = -7.9; p = 0.003) compared to their respective counterparts in large metro areas.
CONCLUSIONS: Rural PCa survivors are less likely to receive treatment. Rural-urban differences in PCEs varied by treatment status.
METHODS: Using 2007-2015 Surveillance Epidemiology and End Results (SEER) data linked to Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, we analyzed survivors\' first survey ≥6 months post-diagnosis. Covariate adjusted linear regressions were used to estimate associations of treatment status (definitive treatment vs. none) and residence (large metro vs. metro vs. rural) with PCE composite and rating measures.
RESULTS: Among 3779 PCa survivors, 1798 (53.2%) and 370 (10.9%) resided in large metro and rural areas, respectively; more rural (vs. large metro) residents were untreated (21.9% vs. 16.7%; p = 0.017). Untreated (vs. treated) PCa survivors reported lower scores for doctor communication (ß = -2.0; p = 0.022), specialist rating (ß = -2.5; p = 0.008), and overall care rating (ß = -2.4; p = 0.006). While treated rural survivors gave higher (ß = 3.6; p = 0.022) scores for obtaining needed care, untreated rural survivors gave lower scores for obtaining needed care (ß = -7.0; p = 0.017) and a lower health plan rating (ß = -7.9; p = 0.003) compared to their respective counterparts in large metro areas.
CONCLUSIONS: Rural PCa survivors are less likely to receive treatment. Rural-urban differences in PCEs varied by treatment status.
摘要：
背景：我们试图评估处于疾病进展中到高风险的局部前列腺癌(PCa)幸存者的患者护理体验(PCE)的城乡差异。
方法：使用2007-2015年监测流行病学和最终结果（SEER）数据与医疗保健提供者和系统的医疗保险消费者评估（CAHPS）调查相关，我们分析了诊断后≥6个月的幸存者\'首次调查.使用协变量调整线性回归来估计治疗状态的关联（确定性治疗与无)和住宅(大型地铁vs.地铁vs.农村)与PCE综合和评级措施。
结果：在3779名PCa幸存者中，1798(53.2%)和370(10.9%)居住在大型地铁和农村地区，分别；更多的农村(与大型地铁)居民未经治疗(21.9%vs.16.7%；p=0.017）。未治疗（与治疗)PCa幸存者报告医生沟通得分较低(β=-2.0；p=0.022)，专家评级(β=-2.5；p=0.008)，和总体护理评级（β=-2.4；p=0.006）。Whiletreatedruralsurvivorsgavehigher(β=3.6;p=0.022)scoresforobtainingneededcare,未经治疗的农村幸存者获得所需护理的得分较低(β=-7.0;p=0.017),健康计划评分较低(β=-7.9;p=0.003)。
结论：农村PCa幸存者接受治疗的可能性较小。PCEs的城乡差异因治疗状况而异。
方法：使用2007-2015年监测流行病学和最终结果（SEER）数据与医疗保健提供者和系统的医疗保险消费者评估（CAHPS）调查相关，我们分析了诊断后≥6个月的幸存者\'首次调查.使用协变量调整线性回归来估计治疗状态的关联（确定性治疗与无)和住宅(大型地铁vs.地铁vs.农村)与PCE综合和评级措施。
结果：在3779名PCa幸存者中，1798(53.2%)和370(10.9%)居住在大型地铁和农村地区，分别；更多的农村(与大型地铁)居民未经治疗(21.9%vs.16.7%；p=0.017）。未治疗（与治疗)PCa幸存者报告医生沟通得分较低(β=-2.0；p=0.022)，专家评级(β=-2.5；p=0.008)，和总体护理评级（β=-2.4；p=0.006）。Whiletreatedruralsurvivorsgavehigher(β=3.6;p=0.022)scoresforobtainingneededcare,未经治疗的农村幸存者获得所需护理的得分较低(β=-7.0;p=0.017),健康计划评分较低(β=-7.9;p=0.003)。
结论：农村PCa幸存者接受治疗的可能性较小。PCEs的城乡差异因治疗状况而异。
