title: Associations Between Patient Perceptions of Communication, Cure, and Other Patient-Related Factors Regarding Patient-Reported Quality of Care Following Surgical Resection of Lung and Colorectal Cancer.
abstract: BACKGROUND
  The objective of the current study was to analyze various patient-related factors related to patient-reported quality of overall and surgical care following surgical resection of lung or colorectal cancer.
  
  
  METHODS
  Between 2003 and 2005, 3,954 patients who underwent cancer-directed surgery for newly diagnosed lung (30.3%) or colorectal (69.7%) cancer were identified from a population- and health system-based survey of participants from multiple US regions. Factors associated with patient-perceived quality of overall and surgical care were analyzed with multivariable logistic regression models.
  
  
  RESULTS
  Overall, 56.7% of patients reported excellent quality of overall care and 67.9% of patients reported excellent quality of surgical care; there was no difference by cancer type (P > 0.05). Factors associated with lower likelihood to report excellent quality of overall and surgical care included female sex, minority race, and the presence of multiple comorbidities (all odds ratio [OR] <1, all P < 0.05). Patients who had higher levels of education (overall quality: OR 1.62; surgical quality: OR 1.26), higher annual income (overall quality: OR 1.29; surgical quality: OR 1.23), and good physical function (overall quality: OR 1.35; surgical quality: OR 1.24) were all more likely to report excellent quality of overall and surgical care (all P < 0.05). Furthermore, patients who reported their physician as having excellent communication skills (overall quality: OR 6.49; surgical quality: OR 3.74) as well as patients who perceived their cancer as likely curable (overall quality: OR 1.17; surgical quality: OR 1.11) were more likely to report excellent quality of overall and surgical care (all P < 0.05).
  
  
  CONCLUSIONS
  Patient-reported quality of care is associated with several factors including race, income, and educational status, as well as physician communication and patient perception of likelihood of cure. Future studies are needed to more closely examine patient-physician relationships and communication barriers, particularly among minority patients and those with lower income and educational status.
authors.affiliation: Department of Surgery, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.
authors.forename: Aslam
authors.initials: A
authors.lastname: Ejaz
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Yuhree
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Winner
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Page
authors.affiliation: Department of Health Science, California State University, Fullerton, CA, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Tisnado
authors.affiliation: Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Sydney E Morss
authors.initials: SE
authors.lastname: Dy
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. tpawlik1@jhmi.edu.|John L. Cameron M.D. Professor of Alimentary Tract Diseases, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 665, Baltimore, MD, 21287, USA. tpawlik1@jhmi.edu.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Pawlik
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D003142:Communication; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D007182:Income; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction / Q000208:ethnology; D010465:Perception; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cancer; Care; Cure; Perception; Quality; Surgery