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A Medicare Claims Analysis of Racial and Ethnic Disparities in the Access to Radiation Therapy Services

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Abstract

Purpose

Reduced access and utilization of radiation therapy (RT) is a well-documented healthcare disparity observed among racial and ethnic minority groups in the USA and a contributor to the inferior health outcomes observed among Black, Hispanic, and Native American patient groups. What is less understood are the points during the process of care following RT consultation at which patients either fail to complete their prescribed treatment or encounter delays. Identification of those points where significant differences exist among different patient groups may help identify opportunities to close gaps in the access of clinically indicated RT.

Methods and Materials

This analysis examines 261,559 RT episodes abstracted from Medicare claims and beneficiary data between 2016 and 2018 to determine rates of treatment initiation following planning and timeliness of treatment completion for different racial groups.

Results

Failure to initiate treatment was observed to be 29.3% relatively greater for Black, Hispanic, and Native American patients than for White and Asian patients. Among episodes for which treatment was initiated, Black and Hispanic patients were observed to require a significantly greater number of calendar days (when adjusted for fraction number) for completion than for White, Asian, and Native American patients.

Conclusions

There appears to be a patient cohort for which RT disparities may be more marginal in their effects—allowing for access to consultation and treatment prescription but not for treatment initiation or timely completion of treatment—and may therefore permit effective solutions to help address current differences in cancer outcomes.

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Data Availability

Medicare Limited Data Set files.

Code Availability

Not applicable.

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Author information

Authors and Affiliations

  1. GenesisCare USA, 2270 Colonial Boulevard, Fort Myers, FL, 33907, USA

    Constantine A. Mantz

  2. Arizona Oncology, Tucson, AR, USA

    Nikhil G. Thaker

  3. Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, USA

    Curtiland Deville Jr

  4. American Society for Radiation Oncology, Fairfax, VA, USA

    Anne Hubbard

  5. Rutgers Cancer Institute of New Jersey, North Brunswick, NJ, USA

    Praveen Pendyala

  6. Radiation Oncology Associates, Arlington Heights, IL, USA

    Najeeb Mohideen

  7. Texas Oncology, Sugar Land, TX, USA

    Vivek Kavadi

  8. Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, USA

    Karen M. Winkfield

Authors
  1. Constantine A. Mantz
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  2. Nikhil G. Thaker
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  3. Curtiland Deville Jr
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  4. Anne Hubbard
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  5. Praveen Pendyala
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  8. Karen M. Winkfield
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Contributions

CAM is responsible for statistical analysis.

Corresponding author

Correspondence to Constantine A. Mantz.

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Conflict of Interest

Dr. Thaker receives consulting fees from McKesson Specialty Health.

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Mantz, C.A., Thaker, N.G., Deville, C. et al. A Medicare Claims Analysis of Racial and Ethnic Disparities in the Access to Radiation Therapy Services. J. Racial and Ethnic Health Disparities 10, 501–508 (2023). https://doi.org/10.1007/s40615-022-01239-0

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  • DOI: https://doi.org/10.1007/s40615-022-01239-0

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