DISP-06. EXAMINING THE INFLUENCE OF NEUROSURGICAL ONCOLOGY PROVIDER ACCESS ON DIFFUSE GLIOMA SURVIVAL OUTCOMES: A NATIONWIDE COUNTY-LEVEL APPROACH

Abstract

Abstract Neuro-oncology as a field has markedly improved understanding of the molecular underpinnings of brain cancer, yet fundamental concepts driving patient outcomes such as access to neuro-oncology subspecialty care remain poorly understood. The aim of this study was to determine the density of neuro-oncologist in the US and correlate disease-specific mortality with provider density. The data was calculated from two national data registries: Centers for Medicare & Medicaid Services (CMS) and Surveillance, Epidemiology, and End RESULTS: (SEER) database. Linear regression modeled three primary outcomes of interest: neurosurgical oncologist per capita, average distance to subspecialist care, and incidence-based mortality of diffuse glioma. Neurosurgical oncologists were classified as providers who billed for CPT code “61510” with at least 10 total services per year over the 5-year duration. In the US, a total of 113 catchment areas were constructed. Mean number of subspecialty providers per capita was 1.80 and the average distance traveled to the nearest provider across the US was 49.9 miles (range 5–151 mi). The mean age-adjusted incidence-based mortality rate among all catchment areas represented was 5.42 deaths per 1000 person-years. Catchment areas with a higher average income were associated with a greater number of subspecialty providers (95% CI 2.13 to 3.44, p < 0.027). Among all US regions, there was no correlation between mortality and provider density or average distance to care. However, Hispanic ethnicity displayed highest incidence-based mortality (r = 0.601, 95% CI -5.02 to -0.944, p < 0.0051). US regions associated with higher poverty and lower average income were associated with greatest mortality (r = 0.45, p < 0.0058). This population study illustrates differences in provider density throughout the United States. Additional research is needed to devise strategies that ensure equitable geographic access in order to optimize patient care and reduce disease burden.