title: The health care experience of patients with cancer during the last year of life: Analysis of the SEER-CAHPS data set.
abstract: Providing high-quality medical care for individuals with cancer during their last year of life involves a range of challenges. An important component of high-quality care during this critical period is ensuring optimal patient satisfaction. The objective of the current study was to assess factors influencing health care ratings among individuals with cancer within 1 year before death.
  
  
  
  The current study used the Surveillance, Epidemiology, and End Results (SEER)-Consumer Assessment of Healthcare Providers and Systems (CAHPS) data set, a new data resource linking patient-reported information from the CAHPS Medicare Survey with clinical information from the National Cancer Institute's SEER program. The study included 5102 Medicare beneficiaries diagnosed with cancer who completed CAHPS between 1998 and 2011 within 1 year before their death. Multivariable logistic regression analyses examined associations between patient demographic and insurance characteristics with 9 measures of health care experience.
  
  
  
  Patients with higher general or mental health status were significantly more likely to indicate excellent experience with nearly all measures examined. Sex, race/ethnicity, and education also were found to be significant predictors for certain ratings. Greater time before death predicted an increased likelihood of higher ratings for health plan and specialist physician. Clinical characteristics were found to have few significant associations with experience of care. Individuals in fee-for-service Medicare plans (vs Medicare Advantage) had a greater likelihood of excellent experience with health plans, getting care quickly, and getting needed care.
  
  
  
  Among patients with cancer within 1 year before death, experience with health plans, physicians, and medical care were found to be associated with sociodemographic, insurance, and clinical characteristics. These findings provide guidance for the development of programs to improve the experience of care among individuals with cancer. Cancer 2017;123:336-344. © 2016 American Cancer Society.
authors.affiliation: RTI International, Research Triangle Park, North Carolina.|Department of Health Services Administration and Policy, Temple University College of Public Health, Philadelphia, Pennsylvania.
authors.forename: Michael T
authors.identifier: 0000-0001-8514-6313
authors.initials: MT
authors.lastname: Halpern
authors.affiliation: RTI International, Research Triangle Park, North Carolina.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Urato
authors.affiliation: Outcomes Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Kent
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D054547:National Cancer Institute (U.S.) / Q000706:statistics & numerical data; D009369:Neoplasms / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D005791:Patient Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010820:Physicians; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D018426:SEER Program / Q000706:statistics & numerical data; D014481:United States
keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS); Epidemiology; Medicare; Surveillance; and End Results (SEER); cancer; patient satisfaction; surveys