Association between Patient Experience Scores and Low Utilization of Hepatocellular Carcinoma Treatment in the United States: A Surveillance, Epidemiology, and End Results–Consumer Assessment of Healthcare Providers and Systems Analysis (SEER-CAHPS)

M. Saad Malik, Michael W. Subrize, Jiangda Ou, Michael P. Curry, Neehar D. Parikh, Victor Novack, Jeffrey L. Weinstein, Muneeb Ahmed, Ammar Sarwar

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To study the experiences of patients with hepatocellular carcinoma (HCC) contributing to treatment discrepancy in the United States. Materials and Methods: Using Surveillance, Epidemiology, and End Results data from National Cancer Institute (NCI), Medicare (2002–2015) beneficiaries with HCC who completed a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey were included. Six CAHPS items (3 global scores: global care rating [GCR], primary doctor rating [PDR], and specialist rating [SR]; 3 composite scores: getting needed care [GNC], getting care quickly [GCQ], and doctor communication [DC]) assessed patient experience. Covariates assessed between treated and nontreated groups included patient, disease, hospital, and CAHPS items. Results: Among 548 patients with HCC, 211 (39%) received treatment and 337 (61%) did not receive treatment. Forty-two percent (GCR), 29% (PDR), 30% (SR), 36% (GNC), 78% (GCQ), and 35% (DC) of patients reported less-than-excellent experiences on the respective CAHPS items. Chronic liver disease (CLD) was present in 52% and liver decompensation (LD) in 60%. A minority of the hospitals were NCI-designated cancer centers (47%), transplant centers (27%), and referral centers (9%). On univariable analysis, patients with at least a high school degree (odds ratio [OR], 1.9), admittance to a ≥400-bed hospital (OR, 2.7), CLD (OR, 3.0), or LD (OR, 1.7) were more likely to receive treatment, whereas older patients (≥75 years) (OR, 0.5) were less likely to receive treatment. On multivariable, patients with CLD (OR, 6.8) and an excellent experience in GNC with a specialist (OR, 10.6) were more likely to receive treatment. Conclusions: HCC treatment discrepancy may be associated with patient-related factors, such as lack of specialist care (GNC), and disease-related factors, such as absence of underlying CLD.

Original languageEnglish
Pages (from-to)102-112.e5
JournalJournal of Vascular and Interventional Radiology
Volume35
Issue number1
DOIs
StatePublished - 1 Jan 2024
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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