Rural/Urban and Racial/Ethnic Inequities in Patient-Reported Health Care Access and Quality among Medicare Beneficiaries with Lung or Colorectal Cancer
The patient perspective of health care access and quality is an important component of assuring patient-centered and value-based care. Although Medicare regularly administers the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) patient surveys among Medicare beneficiaries overall, very little research has examined rural/urban disparities in the patient perspective of health care access and quality among Medicare beneficiaries with a history of cancer.
Incidence and mortality rates remain higher among rural residents for two cancer sites in particular—colorectal (i.e., colon and rectum) and lung (i.e., lung and bronchus). Because incidence and mortality rates for colorectal and lung cancer are higher among rural relative to urban residents, a key concern is whether rural cancer patients experience problems accessing health care and receiving care coordination relative to urban cancer patients.
We hypothesize that rural cancer patients have lower (worse) ratings and reports of their health care access and quality, even when adjusting for other factors. We further hypothesize that rural minority cancer patients have lower (worse) ratings and reports of their health care access and quality than rural White cancer patients, even when adjusting for other factors.
This project will provide timely information about rural/urban and racial/ethnic inequities in health care experiences among Medicare beneficiaries with cancer. The findings may be applied by CMS and other federal policy makers to incentivize improvements in health care delivery and thereby reduce rural/urban and racial/ethnic inequities in cancer care among Medicare beneficiaries.