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2018 ASCO Annual Meeting!


Session: Health Services Research, Clinical Informatics, and Quality of Care

Type: Oral Abstract Session

Time: Friday June 1, 2:45 PM to 5:45 PM

Location: S404

The effect of a lay health worker-led symptom assessment intervention for patients on patient-reported outcomes, healthcare use, and total costs.

Sub-category:
Care Delivery/Models of Care

Category:
Health Services Research, Clinical Informatics, and Quality of Care

Meeting:
2018 ASCO Annual Meeting

Abstract No:
6502

Citation:
J Clin Oncol 36, 2018 (suppl; abstr 6502)

Author(s): Manali I. Patel, David Ramirez, Richy Agajanian, Jay Bhattacharya, Arnold Milstein, Kate Bundorf, CareMore Research Group; Division of Oncology; Clinical Excellence Research Center; Stanford University School of Medicine, Stanford, CA; CareMore, Cerritos, CA; The Oncology Institute of Hope and Innovation, Downey, CA; Stanford University, Stanford, CA; Stanford University School of Medicine, Stanford, CA

Abstract Disclosures

Abstract:

Background: Rising cancer costs demand models that safely lower expenditures and improve patients’ experiences and outcomes. In response, we developed a risk-stratified proactive symptom assessment intervention which consisted of a lay health worker, supervised by a nurse practitioner, who telephonically assessed symptoms weekly for high-risk patients and monthly for low-risk patients. We implemented the intervention in an oncology group with collaboration from a health plan to test the effect on patient-reported outcomes, healthcare use and cost. Methods: We enrolled all newly diagnosed health plan beneficiaries with Stage 3 and 4 cancer from 11/2014 through 9/2015. We evaluated patient-reported satisfaction, emotional and mental health with validated assessments at enrollment and 5-months post-enrollment. We compared healthcare use and costs to all patients with Stage 3 and 4 cancer diagnosed from 11/1/2013-10/31/2014 (control). We assessed differences in demographic and clinical factors using chi-square and t-tests. To evaluate differences in healthcare use and costs we used generalized linear models adjusted for age, stage, co-morbidity, cancer diagnosis, and length of follow-up. Results: There were 186 patients in the intervention and 102 in the control. In both arms, median age was 78 years, 55% were female, and gastrointestinal malignancies were the highest proportion of diagnoses. There were statistically significant improvements in mental and emotional health (p < 0.05) and satisfaction with care (p < 0.05) at 5-months follow-up compared with baseline. Patients in the intervention had significantly lower mean number of inpatient admissions per quarter (0.72 vs. 1.02, p = 0.03); mean number of emergency department visits per quarter (0.61 vs. 0.92, p = 0.04), and lower median total healthcare costs ($22344 vs $28414, p = 0.03) as compared to the control. Conclusions: A lay health worker-led symptom assessment intervention significantly improved patient satisfaction and reduced healthcare use and costs and may represent one solution to improve care for patients.

 
Other Abstracts in this Sub-Category:

 

1. Lung cancer screening rates: Data from the lung cancer screening registry.

Meeting: 2018 ASCO Annual Meeting Abstract No: 6504 First Author: Danh Pham
Category: Health Services Research, Clinical Informatics, and Quality of Care - Care Delivery/Models of Care

 

2. Integrating tobacco treatment into cancer care: A first snapshot of RCT findings.

Meeting: 2018 ASCO Annual Meeting Abstract No: 6505 First Author: Elyse R. Park
Category: Health Services Research, Clinical Informatics, and Quality of Care - Care Delivery/Models of Care

 

3. Implementation of breast cancer pathway for genetic counseling and testing in multi-state health system.

Meeting: 2018 ASCO Annual Meeting Abstract No: 6521 First Author: Stephanie L. Graff
Category: Health Services Research, Clinical Informatics, and Quality of Care - Care Delivery/Models of Care

 

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