Impact of diffuse large B-cell lymphoma on visits to different provider specialties among elderly Medicare beneficiaries: Challenges for care coordination

Rahul Garg, Usha Sambamoorthi, Xi Tan, Soumit K. Basu, Treah Haggerty, Kimberly M. Kelly

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Newly diagnosed diffuse large B-cell lymphoma (DLBCL) can pose significant challenges to care coordination. We utilized a social-ecological model to understand the impact of DLBCL diagnosis on visits to primary care providers (PCPs) and specialists, a key component of care coordination, over a 3-year period of cancer diagnosis and treatment. We used hurdle models and multivariable logistic regression with the Surveillance Epidemiology and End Result-Medicare linked dataset to analyze visits to PCPs and specialists by DLBCL patients (n = 5,455) compared with noncancer patients (n = 14,770). DLBCL patients were more likely to visit PCPs (adjusted odds ratio, AOR [95% confidence interval, CI]: 1.25 [1.18, 1.31]) and had greater number of visits to PCPs (β, SE: 0.384, -0.014) than noncancer patients. Further, DLBCL patients were more likely to have any visit to cardiologists (AOR [95% CI]: 1.40 [1.32, 1.47]), endocrinologists (1.43, [1.21, 1.70]), and pulmonologists (1.51 [1.36, 1.67]) than noncancer patients. Among DLBCL patients, the number of PCP visits markedly increased during the treatment period compared with the baseline period (β, SE: 0.491, -0.028) and then decreased to baseline levels (-0.464, -0.022). Visits to PCPs and specialists were much more frequent for DLBCL patients than noncancer patients, which drastically increased during the DLBCL treatment period for chronic care. More chronic conditions, treatment side effects, and frequent testing may have increased visits to PCPs and specialists. Interventions to improve care coordination may need to target the DLBCL treatment period, when patients are most vulnerable to poor care coordination.

Original languageEnglish
Pages (from-to)386-399
Number of pages14
JournalTranslational Behavioral Medicine
Volume8
Issue number3
DOIs
StatePublished - 23 May 2018

Keywords

  • Care coordination
  • Chronic care
  • Non-Hodgkin's lymphoma
  • Physician visits
  • Specialist visits

Fingerprint

Dive into the research topics of 'Impact of diffuse large B-cell lymphoma on visits to different provider specialties among elderly Medicare beneficiaries: Challenges for care coordination'. Together they form a unique fingerprint.

Cite this