scholarly journals Factors Associated With Use of a High-Volume Cancer Center by Black Women With Ovarian Cancer

2019 ◽  
Vol 15 (9) ◽  
pp. e769-e776
Author(s):  
Renee A. Cowan ◽  
Elyse Shuk ◽  
Maureen Byrne ◽  
Nadeem R. Abu-Rustum ◽  
Dennis S. Chi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Black Women ◽  
Insurance Coverage ◽  
High Volume ◽  
Cancer Center ◽  
Black Communities ◽  
Related Factors ◽  
Self Advocacy ◽  
Factors Affecting ◽  
Institutional Review

OBJECTIVE: Disparities exist between population subgroups in the use of gynecologic oncologists and high-volume hospitals. The objectives of this study were to explore the experiences of black women obtaining ovarian cancer (OC) care at a high-volume center (HVC) and to identify patient-, provider-, and systems-related factors affecting their access to and use of this level of care. MATERIALS AND METHODS: Twenty-one semistructured interviews were conducted as part of an institutional review board–approved protocol with women who self-identified as black or African American, treated for OC at a single HVC from January 2013 to May 2017. Recurring themes were identified in transcribed interviews through the process of independent and collaborative thematic content analysis. RESULTS: Five themes were identified: (1) internal attributes contributing to black women’s ability/desire to be treated at an HVC, (2) pathways to high- and low-volume centers, (3) obstacles to obtaining care, (4) potential barriers for black women interested in treatment at an HVC, and (5) suggestions for improving HVC use by black women. Study participants who successfully accessed care were comfortable navigating the health care system, understood the importance of self-advocacy, and valued the expertise of an HVC. Barriers to obtaining care at an HVC included lack of knowledge about the HVC, lack of referral, transportation difficulties, and lack of insurance coverage. CONCLUSION: In this qualitative study, black women treated at an HVC shared attributes and experiences that helped them access care. There is a need to collaborate with black communities and establish interventions to reduce barriers, facilitate access, and disseminate information about the value of receiving care for OC at an HVC.

Factors associated with the access and use of a high-volume cancer center by black women with ovarian cancer: A qualitative study

2018 ◽  
Vol 149 ◽  
pp. 136
Author(s):  
R.A. Cowan ◽  
E. Shuk ◽  
M.E. Byrne ◽  
N.R. Abu-Rustum ◽  
D.S. Chi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Black Women ◽  
Qualitative Study ◽  
High Volume ◽  
Cancer Center ◽  
Factors Associated

Incorporation of HIPEC into a high volume ovarian cancer program: Initial results and outcomes.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17040-e17040
Author(s):  
Aliza L. Leiser ◽  
Eugenia Girda ◽  
Ruth D. Stephenson ◽  
Mihae Song ◽  
Alexandre Buckley de Meritens ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Progression Free Survival ◽  
High Volume ◽  
Cancer Center ◽  
R0 Resection ◽  
Consolidation Chemotherapy ◽  
Fallopian Tube Cancer ◽  
Primary Surgery ◽  
Cancer Program ◽  
To Receive

e17040 Background: HIPEC showed a progression free survival when incorporated into interval cytoreductive surgery for ovarian cancer patients in a recent phase lll trial. This has led to a paradigm shift at many institutions and the consideration of HIPEC. The goal of this study is to report on the initiation of this program and change in practice at a high volume cancer center over a period of 1 year. Methods: Reviewed surgical cases from 1/2018 through 1/2019 where patients were thought to have a primary ovarian or fallopian tube cancer. Variables included age, stage, histology, primary or interval debulking surgery, number of neoadjuvant (NAJ) chemotherapy cycles. HIPEC patients were selected out and variables examined included intraoperative procedures, optimal cytoreduction, type of chemotherapy administered, postoperative complications, and ability to receive consolidation chemotherapy. Results: 35 cases where ovarian cancer known or suspected preoperatively. 23 patients had primary surgery consisting of tah/bso/surgical staging/tumor debulking. 0/23 of these patients were offered HIPEC chemotherapy as an upfront strategy. 12 patients received neoadjuvant chemotherapy for recurrent (2) or advanced (10) disease. 11/12 of these patients proceeded to an interval surgery. 6/11 (54%) were planned for HIPEC. This was aborted in 1/6 because of thrombocytopenia. 5/6 patients went on to receive HIPEC. They received 3-6 cycles of NAJ chemotherapy, platinum and taxane. 3/5 also received preoperative Avastin. All had R0 resection. 1 patient had a bowel resection. Either carboplatin or cisplatin was used for HIPEC over 90 minutes. 2/5 patients had postoperative G2-3 cytopenias. 3/5 patients were able to receive consolidation chemotherapy, 2 of them within six weeks of surgery and with Avastin containing regimens. Conclusions: In a large volume center initiating a HIPEC ovarian cancer program in less than one years’ time, HIPEC was offered to 50% of patients undergoing interval debulking for Stage III or IV serous ovarian cancer after NAJ chemotherapy and in rare cases for patients with recurrent cancer planned for cytoreduction. Patients may go on to receive postoperative chemotherapy but may have prolonged cytopenias and consolidation therapy delays. HIPEC was not incorporated into an upfront surgical strategy.[Table: see text]

The effect of Black versus White race on perceptions of care within a cohort of women treated for ovarian cancer at a high-volume cancer center

2021 ◽  
Vol 162 ◽  
pp. S289-S290
Author(s):  
Allison Saiz ◽  
Amy Alexander ◽  
Dominique Kinnett-Hopkins ◽  
Roya Zandi ◽  
Susan Folsom ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
High Volume ◽  
Cancer Center ◽  
White Race ◽  
Perceptions Of Care

scholarly journals Patient Involvement in Safe Delivery: A Qualitative Study

2015 ◽  
Vol 8 (6) ◽  
pp. 33 ◽  
Author(s):  
ForozUn Olfati ◽  
Saeid Asefzadeh ◽  
Nasrin Changizi ◽  
Afsaneh Keramat ◽  
Masud Yunesian
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Patient Involvement ◽  
Insurance Coverage ◽  
Labor Pain ◽  
Structured Interviews ◽  
Related Factors ◽  
Factors Affecting ◽  
Safe Delivery ◽  
Colaizzi's Method

<p><strong>INTRODUCTION: </strong>Patient involvement in safe delivery planning is considered important yet not widely practiced. The present study aimed at identifythe factors that affect patient involvementin safe delivery, as recommended by parturient women.</p> <p><strong>METHODS:</strong> This study was part of a qualitative research conducted by content analysis method and purposive sampling in 2013.The data were collected through 63 semi-structured interviews in4 hospitalsand analyzed using thematic content analysis. The participants in this research were women before discharge and after delivery. Findings were analyzed using Colaizzi's method.</p> <p><strong>RESULTS: </strong>Four categories of factors that could affect patient involvement in safe deliveryemerfed from our analysis: patient-related (true and falsebeliefs, literacy, privacy, respect for patient), illness-related (pain, type of delivery, patient safety incidents), health care professional-relatedand task-related factors (behavior, monitoring &amp;training), health care setting-related (financial aspects, facilities).</p> <p><strong>CONCLUSION: </strong>More research is needed to explore the factors affecting the participation of mothers. It is therefore, recommended to: 1) take notice of mother education, their husbands, midwives and specialists; 2) provide pregnant women with insurance coverage from the outset of pregnancy, especially during prenatal period; 3) form a labor pain committee consisting of midwives, obstetricians, and anesthesiologists in order to identify the preferred painless labor methods based on the existing facilities and conditions, 4) carry out research on observing patients’ privacy and dignity; 5) pay more attention on the factors affecting cesarean</p>

Impact of geography and travel distance on outcomes in epithelial ovarian cancer: a national cancer database analysis

2020 ◽  
pp. ijgc-2020-001807
Author(s):  
Ava Daruvala ◽  
F Lee Lucas ◽  
Jesse Sammon ◽  
Christopher Darus ◽  
Leslie Bradford
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Healthcare Delivery ◽  
High Volume ◽  
Cox Proportional Hazards ◽  
Travel Distance ◽  
Cancer Center ◽  
National Cancer Database ◽  
Significant Difference ◽  
The Impact

BackgroundAs ovarian cancer treatment shifts to provide more complex aspects of care at high-volume centers, almost a quarter of patients, many of whom reside in rural counties, will not have access to those centers or receive guideline-based care.ObjectiveTo explore the association between proximity of residential zip code to a high-volume cancer center with mortality and survival for patients with ovarian cancer.MethodsThe National Cancer Database was queried for cases of newly diagnosed ovarian cancer between January 2004 and December 2015. Our predictor of interest was distance traveled for treatment. Our primary outcomes were 30-day mortality, 90-day mortality, and overall survival. The effect of treatment on survival was analyzed with the Kaplan-Meier method. Multiple logistic regression for binary outcomes and Cox proportional hazards regression for overall survival were used to assess the effect of distance on outcome, controlling for potential confounding variables.ResultsA total of 115 540 patients were included. There was no statistically significant difference in 30- or 90-day mortality among any of the travel distance categories. A statistically significant decrease in 30-day re-admission was found among patients who lived further away from the treating facility. A total of 105 529 patients were available for survival analysis, and survival curves significantly differed between distance strata (p<0.0001). The adjusted regression models demonstrated increased long-term mortality in patients who lived farther away from the treating facility after controlling for potential confounding.ConclusionAlthough 30- and 90-day mortality do not differ by travel distance, worse survival is observed among women living >50 miles from a high-volume treatment facility. With a national policy shift toward centralization of complex care, a better understanding of the impact of distance on survival in patients with ovarian cancer is crucial. Our findings inform the practice of healthcare delivery, especially in rural settings.

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