Documenting Time to First Treatment for Patients with Lung Cancer

Marianna B Shershneva


Background: Some lung cancer patients experience unnecessary delays in their care in the US. However, these delays are not well-documented outside the Veterans Administration Hospital system. We conducted a study to pilot-test patient interviews as a method of documenting timeliness of care. The results will be utilized in future studies to inform the development of interventions to reduce time to treatment for lung cancer patients.

Methods: We recruited 36 patients with lung cancer. The interview collecting 11 dates pertinent to lung cancer care was piloted with 20 patients. We subsequently interviewed 16 additional patients and reviewed their charts to analyze the accuracy of patient-reported data with chart-reported data.

Results: For 16 patients: 1) patient-reported and chart-reported median time from the first visit to provider to the first treatment was the same—41.5 days, 2) Lin’s correlation coefficient indicated almost perfect agreement (ρ >0.99) for five dates, and poor agreement (ρ <0.90) for six dates, 3) median time difference between patient-reported and chart-reported dates varied from 0 to 8 days. Based on all interviews, median time from the first visit to the first treatment was 52.5 days, ranging from 5 to 2000 days. For all 36 patients, one or more possibly avoidable delays were experienced by 24 (67%) of patients.

Conclusion: Interviewing patients has limitations but it can be a reliable method of collecting dates regarding lung cancer care. There are multiple opportunities to reduce time to lung cancer treatment, but more research is needed to better understand delays.

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