Diversity in the Cancer Care Workforce

癌症护理人员队伍的多样性

基本信息

批准号：
10655717
负责人：
Dowin Boatright
金额：
$ 85.88万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-23 至 2026-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10655717
关键词：
Address Affect American Medical Association Area Association of American Medical Colleges Black race Businesses Caring Characteristics Clinical Data Colorectal Cancer Data Data Linkages Data Sources Diagnosis Disparity Early Diagnosis Equity Ethnic Origin General Population Geographic Locations Geography Goals Guidelines Health system Healthcare Market Hematology Individual Knowledge Latinx Latinx population Literature Malignant Neoplasms Malignant neoplasm of lung Malignant neoplasm of prostate Medicare Medicine Methods Oncologist Oncology Outcome Patient Care Patient-Focused Outcomes Patients Patterns of Care Performance Physicians Play Population Provider Public Health Quality of Care Race Research Retrospective Studies Role SEER Program Science Screening for cancer Stage at Diagnosis Structural Racism Training Programs Variant Work cancer care cancer diagnosis cancer health disparity cancer therapy clinical care contextual factors end of life end of life care ethnic disparity ethnic diversity geographic difference improved indexing individual patient malignant breast neoplasm medical specialties neoplasm registry novel novel strategies population based racial disparity racial diversity sociodemographics

项目摘要

Significance: The racial and ethnic distribution of the cancer workforce contrasts starkly with that of the general population. Only 2-3% of oncologists identify as Black or Latinx, compared to 13% and 18% of the U.S. population, respectively. While evidence from the business literature suggests that diversity in teams impacts organizational performance, it is not known whether provider team diversity as well as patient-provider racial and ethnic concordance is associated with quality of cancer-related care and outcomes. If the diversity of teams (physician patient-sharing networks) does indeed improve cancer care, this benefit could improve care for all patients, regardless of the individual patient's race or ethnicity or the race or ethnicity of their provider. Objective: Our over-arching goal is to generate actionable evidence to inform efforts to improve cancer workforce diversity and increase equity in cancer care. Our hypothesis is that the racial and ethnic representation of the oncology workforce varies across regions and patient-sharing networks and that this variation is associated with clinical care. Previously, addressing this knowledge gap has not been possible due to a lack of available data combining physician race and ethnicity with patient clinical data. Specific Aims: We propose a retrospective study using a novel data linkage between the American Medical Association; Association of American Medical Colleges; Surveillance, Epidemiology and End Results population-based cancer registries; and Medicare data to address the following aims: (Aim 1) To ethnic and sharing and regions patient-sharing or assess changes in racial and diversity of the cancer physician and trainee workforce between 2015 and 2020, according to specialty regional healthcare market and ( Aim 1A ) to assess the racial and ethnic diversity of physician patient- networks providing cancer care during the period 2015 – 2020; ( Aim 2 ) To assess variation in racial ethnic representativeness of the oncology workforce across specialty, physician networks, and geographic and (Aim 2A) to identify whether underrepresented in medicine (URM) physicians, as well as physician networks containing a higher proportion of URM physicians, are more likely to care for Black Latinx patients with cancer; ( Aim 3 )To assess geographic and health system contextual factors (e.g. health system factors, area sociodemographics, and structural racism) associated with physician diversity within physician patient-sharing networks; (Aim 4) Among patients diagnosed with invasive lung, prostate, breast, or colorectal cancer during 2015-2019, to networks Receipt assess the association between the racial diversity of their physician , and ( Aim 4A) Early stage at diagnosis for patients with colorectal or breast cancer, ( Aim 4B ) of guideline-concordant cancer treatment, and ( Aim 4C) Quality of end of life care. Through this study, we will create a novel data linkage, and incorporate network science methods to further our understanding of the cancer physician workforce and to identify whether physician team diversity may serve as a previously unidentified mechanism of reducing racial and ethnic disparities in cancer outcomes.

意义：癌症劳动力的种族和民族分布与癌症劳动力的种族和民族分布形成鲜明对比。普通人群中只有 2-3% 的肿瘤学家认为自己是黑人或拉丁裔，而美国这一比例为 13% 和 18%。商业文献的证据表明，团队的多样性会产生影响。组织绩效，目前尚不清楚提供者团队的多样性以及患者-提供者的种族是否如果团队的多样性，种族一致性与癌症相关护理和结果的质量有关。（医生患者共享网络）确实改善了癌症护理，这种好处可以改善所有人的护理患者，无论患者个人的种族或民族或其提供者的种族或民族。目标：我们的首要目标是生成可操作的证据，为改善癌症的努力提供信息劳动力多样性和增加癌症护理的公平性我们的假设是种族和民族。肿瘤学人员的代表性因地区和患者共享网络而异，并且这以前，由于这种知识差距与临床护理有关，因此不可能解决这一问题。缺乏将医生种族和民族与患者具体目标相结合的可用数据：我们提出一项回顾性研究，利用美国医学会之间的新颖数据链接；美国医学院协会；基于人群的监测、流行病学和最终结果癌症登记处；和医疗保险数据，以实现以下目标：（目标 1）种族和分享和地区患者共享或者评估种族和群体的变化根据专业，2015 年至 2020 年癌症医生和实习生队伍的多样性区域医疗保健市场和（目标 1A）评估医生患者的种族和民族多样性 2015 年至 2020 年期间提供癌症护理的网络（目标 2）评估种族差异；跨专业、医师网络和地理区域的肿瘤学劳动力的种族代表性（目标 2A）确定医学 (URM) 医师以及医师的代表性是否不足包含较高比例 URM 医生的网络更有可能照顾黑人拉丁裔癌症患者；（目标 3）评估地理和卫生系统背景因素（例如健康状况）与医生多样性相关的系统因素、地区社会人口统计和结构性种族主义）医生患者共享网络；（目标 4）诊断患有侵袭性肺、前列腺、乳腺癌或其他疾病的患者 2015-2019 年结直肠癌网络收据评估医生的种族多样性之间的关联，以及（目标 4A）结直肠癌或乳腺癌患者的早期诊断，（目标 4B）符合指南的癌症治疗，以及（目标 4C）临终关怀的质量。研究中，我们将创建一种新颖的数据链接，并结合网络科学方法来进一步推进我们的研究了解癌症医生队伍，并确定医生团队的多样性是否可以作为一种先前未知的减少癌症结果中种族和民族差异的机制。