Lay navigation across the cancer continuum for older cancer survivors

Equally beneficial for Black and White survivors?

Maria Pisu, Gabrielle B. Rocque, Bradford E. Jackson, Kelly M. Kenzik, Pradeep Sharma, Courtney P. Williams, Elizabeth A. Kvale, Richard A. Taylor, Grant R. Williams, Andres Azuero, Yufeng Li, Aras Acemgil, Michelle Martin, Wendy Demark-Wahnefried, Yasemin Turkman, Mona Fouad, Rodney P. Rocconi, Margaret Sullivan, Guilherme Cantuaria, Edward E. Partridge & 1 others Karen Meneses

Research output: Contribution to journalArticle

Abstract

Objectives: The Patient Care Connect Program (PCCP), through lay navigators' distress assessments and assistance, was shown to lower healthcare utilization and costs in older cancer survivors. PCCP benefits and assistance needs for disadvantaged minorities (e.g., Black) vs. Whites are unknown. Materials and Methods: We examined the PCCP impact with retrospective analyses of Medicare claims (2012–2015). Outcomes were quarterly costs and utilization (emergency room (ER), hospitalizations) for navigated and matched survivors. Repeated measures generalized linear models with normal (costs), and Poisson (utilization) distributions assessed differences in trends overall and separately for Blacks and Whites. With distress data for navigated survivors, we assessed high distress (score > 3), ≥1 distress cause (overall, by domain), and ≥ 1 assistance request by minority group. Results: Beneficiaries were: 772 Black and 5350 White navigated, and 770 Black and 5348 White matched survivors. Impact was: i) costs: -$557.5 Blacks (p <.001), −$813.4 Whites (p <.001); ii) ER: Incidence Rate Ratio (IRR) 0.97 Blacks (NS), 0.93 Whites (p <.001); iii) hospitalizations: IRR 0.97 Blacks (NS), 0.91 Whites (p <.001). There was no significant difference in impact across minority groups. No significant differences were found in high distress (29% Black, 25.1% White), ≥1 distress cause (61.6% Black, 57.8% White), or ≥ 1 assistance request (64.5% Black, 59.1% White). Blacks were more likely to have ≥1 distress cause in the Practical domain. Conclusion: The PCCP may benefit both Black and White older cancer survivors. Programs should consider the proportion of older survivors with high distress, and the specific needs of minorities.

Original languageEnglish (US)
Pages (from-to)779-786
Number of pages8
JournalJournal of Geriatric Oncology
Volume10
Issue number5
DOIs
StatePublished - Sep 1 2019

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Survivors
Patient Care
Neoplasms
Minority Groups
Costs and Cost Analysis
Hospital Emergency Service
Hospitalization
Insurance Claim Review
Poisson Distribution
Incidence
Vulnerable Populations
Medicare
hydroquinone
Health Care Costs
Linear Models

All Science Journal Classification (ASJC) codes

  • Oncology
  • Geriatrics and Gerontology

Cite this

Pisu, M., Rocque, G. B., Jackson, B. E., Kenzik, K. M., Sharma, P., Williams, C. P., ... Meneses, K. (2019). Lay navigation across the cancer continuum for older cancer survivors: Equally beneficial for Black and White survivors? Journal of Geriatric Oncology, 10(5), 779-786. https://doi.org/10.1016/j.jgo.2018.10.013

Lay navigation across the cancer continuum for older cancer survivors : Equally beneficial for Black and White survivors? / Pisu, Maria; Rocque, Gabrielle B.; Jackson, Bradford E.; Kenzik, Kelly M.; Sharma, Pradeep; Williams, Courtney P.; Kvale, Elizabeth A.; Taylor, Richard A.; Williams, Grant R.; Azuero, Andres; Li, Yufeng; Acemgil, Aras; Martin, Michelle; Demark-Wahnefried, Wendy; Turkman, Yasemin; Fouad, Mona; Rocconi, Rodney P.; Sullivan, Margaret; Cantuaria, Guilherme; Partridge, Edward E.; Meneses, Karen.

In: Journal of Geriatric Oncology, Vol. 10, No. 5, 01.09.2019, p. 779-786.

Research output: Contribution to journalArticle

Pisu, M, Rocque, GB, Jackson, BE, Kenzik, KM, Sharma, P, Williams, CP, Kvale, EA, Taylor, RA, Williams, GR, Azuero, A, Li, Y, Acemgil, A, Martin, M, Demark-Wahnefried, W, Turkman, Y, Fouad, M, Rocconi, RP, Sullivan, M, Cantuaria, G, Partridge, EE & Meneses, K 2019, 'Lay navigation across the cancer continuum for older cancer survivors: Equally beneficial for Black and White survivors?', Journal of Geriatric Oncology, vol. 10, no. 5, pp. 779-786. https://doi.org/10.1016/j.jgo.2018.10.013
Pisu, Maria ; Rocque, Gabrielle B. ; Jackson, Bradford E. ; Kenzik, Kelly M. ; Sharma, Pradeep ; Williams, Courtney P. ; Kvale, Elizabeth A. ; Taylor, Richard A. ; Williams, Grant R. ; Azuero, Andres ; Li, Yufeng ; Acemgil, Aras ; Martin, Michelle ; Demark-Wahnefried, Wendy ; Turkman, Yasemin ; Fouad, Mona ; Rocconi, Rodney P. ; Sullivan, Margaret ; Cantuaria, Guilherme ; Partridge, Edward E. ; Meneses, Karen. / Lay navigation across the cancer continuum for older cancer survivors : Equally beneficial for Black and White survivors?. In: Journal of Geriatric Oncology. 2019 ; Vol. 10, No. 5. pp. 779-786.
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title = "Lay navigation across the cancer continuum for older cancer survivors: Equally beneficial for Black and White survivors?",
abstract = "Objectives: The Patient Care Connect Program (PCCP), through lay navigators' distress assessments and assistance, was shown to lower healthcare utilization and costs in older cancer survivors. PCCP benefits and assistance needs for disadvantaged minorities (e.g., Black) vs. Whites are unknown. Materials and Methods: We examined the PCCP impact with retrospective analyses of Medicare claims (2012–2015). Outcomes were quarterly costs and utilization (emergency room (ER), hospitalizations) for navigated and matched survivors. Repeated measures generalized linear models with normal (costs), and Poisson (utilization) distributions assessed differences in trends overall and separately for Blacks and Whites. With distress data for navigated survivors, we assessed high distress (score > 3), ≥1 distress cause (overall, by domain), and ≥ 1 assistance request by minority group. Results: Beneficiaries were: 772 Black and 5350 White navigated, and 770 Black and 5348 White matched survivors. Impact was: i) costs: -$557.5 Blacks (p <.001), −$813.4 Whites (p <.001); ii) ER: Incidence Rate Ratio (IRR) 0.97 Blacks (NS), 0.93 Whites (p <.001); iii) hospitalizations: IRR 0.97 Blacks (NS), 0.91 Whites (p <.001). There was no significant difference in impact across minority groups. No significant differences were found in high distress (29{\%} Black, 25.1{\%} White), ≥1 distress cause (61.6{\%} Black, 57.8{\%} White), or ≥ 1 assistance request (64.5{\%} Black, 59.1{\%} White). Blacks were more likely to have ≥1 distress cause in the Practical domain. Conclusion: The PCCP may benefit both Black and White older cancer survivors. Programs should consider the proportion of older survivors with high distress, and the specific needs of minorities.",
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T1 - Lay navigation across the cancer continuum for older cancer survivors

T2 - Equally beneficial for Black and White survivors?

AU - Pisu, Maria

AU - Rocque, Gabrielle B.

AU - Jackson, Bradford E.

AU - Kenzik, Kelly M.

AU - Sharma, Pradeep

AU - Williams, Courtney P.

AU - Kvale, Elizabeth A.

AU - Taylor, Richard A.

AU - Williams, Grant R.

AU - Azuero, Andres

AU - Li, Yufeng

AU - Acemgil, Aras

AU - Martin, Michelle

AU - Demark-Wahnefried, Wendy

AU - Turkman, Yasemin

AU - Fouad, Mona

AU - Rocconi, Rodney P.

AU - Sullivan, Margaret

AU - Cantuaria, Guilherme

AU - Partridge, Edward E.

AU - Meneses, Karen

PY - 2019/9/1

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N2 - Objectives: The Patient Care Connect Program (PCCP), through lay navigators' distress assessments and assistance, was shown to lower healthcare utilization and costs in older cancer survivors. PCCP benefits and assistance needs for disadvantaged minorities (e.g., Black) vs. Whites are unknown. Materials and Methods: We examined the PCCP impact with retrospective analyses of Medicare claims (2012–2015). Outcomes were quarterly costs and utilization (emergency room (ER), hospitalizations) for navigated and matched survivors. Repeated measures generalized linear models with normal (costs), and Poisson (utilization) distributions assessed differences in trends overall and separately for Blacks and Whites. With distress data for navigated survivors, we assessed high distress (score > 3), ≥1 distress cause (overall, by domain), and ≥ 1 assistance request by minority group. Results: Beneficiaries were: 772 Black and 5350 White navigated, and 770 Black and 5348 White matched survivors. Impact was: i) costs: -$557.5 Blacks (p <.001), −$813.4 Whites (p <.001); ii) ER: Incidence Rate Ratio (IRR) 0.97 Blacks (NS), 0.93 Whites (p <.001); iii) hospitalizations: IRR 0.97 Blacks (NS), 0.91 Whites (p <.001). There was no significant difference in impact across minority groups. No significant differences were found in high distress (29% Black, 25.1% White), ≥1 distress cause (61.6% Black, 57.8% White), or ≥ 1 assistance request (64.5% Black, 59.1% White). Blacks were more likely to have ≥1 distress cause in the Practical domain. Conclusion: The PCCP may benefit both Black and White older cancer survivors. Programs should consider the proportion of older survivors with high distress, and the specific needs of minorities.

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