Results Summary

What was the research about?

In this study, the research team tested a patient-centered approach to care at offices where oncologists treat patients. Oncologists are doctors specially trained to treat patients with cancer. The approach included

  • Care that focuses on the whole person, including the patients’ goals, ability to care for themselves, and cultural and language needs
  • Easy access to care, such as same-day appointments and quick responses to questions after office hours
  • Better communication with patients and caregivers about test results, medicines, or care plans
  • Coordinated care between patients and their oncologists, primary care doctors, and other doctors

The research team tested the patient-centered approach at five oncology offices. The study compared this approach to usual care at 18 other offices. The team wanted to learn how the patient-centered approach affected patients’ doctor visits, hospital stays, and experiences with care.

What were the results?

Doctor visits and hospital stays. Compared with patients at offices with usual care, patients at offices using the patient-centered approach

  • Went to see specialists (such as their oncologist and radiologist) more often
  • Saw their primary care doctor, went to the emergency room, or stayed in the hospital about the same number of times as the usual care group

Patient experiences. Compared with patients at other offices, patients at offices using the patient-centered approach had

  • Better experiences making shared decisions with their doctor
  • Worse experiences accessing care
  • Worse experiences giving information to and getting information from their doctor
  • Similar experiences talking with their doctor about their feelings
  • Similar experiences managing their own care

Quality of care. Compared to the beginning of the study, patients at offices using the patient-centered approach were

  • More likely to have their symptoms correctly assessed and their care managed
  • Less likely to have a doctor follow-up about problems they talked about in a visit

Who was in the study?

Patients in the study got care at 23 oncology offices in Pennsylvania. The average age of patients was 61. On average, 65 percent of patients were female. In addition, an average of 87 percent of patients were white, and 11 percent were black. Another 1 percent were Asian, and 1 percent were other races.

What did the research team do?

The research team compared data from patients at the 5 offices using patient-centered care with the 18 offices using usual care. The team compared the data before the start of the study and again after the five offices started using the patient-centered approach.

Using health insurance records, the team looked at doctor visits, hospital stays, and emergency room visits for 30,843 patients across all the offices. The team also asked 715 patients at the start of the study and 437 patients at the end about their experiences with care. Next, the team looked at medical records to see if the quality of care changed from the beginning of the study to the end.

During the study, a group of patients and patient advocates gave advice to the research team on the study design and the patient-centered approach.

What were the limits of the study?

The research team did not select the five offices that offered to provide patient-centered care by chance. The findings may reflect things about the offices other than whether they used the new patient-centered approach. For example, patient traits were different between the two groups of offices. Also, the team didn’t know about other approaches for patient-centered care that the offices may have been using. The team can’t say how important the findings are to the actual quality of the care that patients received.

Future research could assign offices by chance to use the patient-centered care approach or continue with usual care. Studies could also test other approaches that support patient-centered care at oncology offices.

How can people use the results?

Researchers can use these results as they look for ways to improve patient care at oncology offices.

Final Research Report

View this project's final research report.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.

Peer review identified the following strengths and limitations in the report:

  • Reviewers asked for the report to place the study within the larger healthcare context. The investigators added language to the background and discussion sections describing the changes to value-based oncology care that occurred during the course of the study and may have affected study results.
  • Reviewers suggested that the investigators add a study limitation related to the low survey response rate, but the authors pointed out that their response rate was similar to other Consumer Assessment of Health Providers and Systems (CAHPS) surveys. In addition, because the surveys were cross-sectional, the researchers were not aiming for including the same respondents before and after the intervention. For this reason, the researchers did not consider the low response rate as indicative of study drop-out.

Conflict of Interest Disclosures

Project Information

Sarah Scholle, DrPH, MPH
National Committee for Quality Assurance
$1,987,855
10.25302/1.2020.IH.12114383
Evaluating the Impact of Patient-Centered Oncology Care

Key Dates

May 2013
September 2018
2013
2018

Study Registration Information

Tags

Has Results
Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Funding Opportunity Type
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
Research Priority Area
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: January 25, 2023