Health care satisfaction among older cancer survivors.

Abstract

18 Background: Cancer survivors experience unique challenges in receiving needed health care services. There is little information on individual-level factors affecting satisfaction with health care services among survivors. Methods: This study used satisfaction ratings provided by cancer survivors in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare Survey linked to data from NCI’s SEER Program (SEER-CAHPS). CAHPS data on self-reported general and mental health status and five composite measures of satisfaction with health care interactions (customer service, doctor communications, getting care quickly, getting needed care, and getting prescription drugs) were linked to patient sociodemographic and cancer characteristics from SEER. Medicare beneficiaries diagnosed with cancer in SEER regions 1997-2011 participating in CAHPS Medicare Survey > 1 year after cancer diagnosis were included. The study included individuals alive > 1 year following CAHPS completion, at least age 66, and diagnosed with non-metastatic breast, colorectal, lung, or prostate cancer. Analyses were performed separately by cancer type. Results: Among 23,969 cancer survivors with linked SEER-CAHPS data, higher general health was associated with higher satisfaction for all survivors except those diagnosed with lung cancer; higher mental health predicted higher satisfaction only among lung and prostate cancer survivors. Higher education predicted lower satisfaction among breast cancer survivors. Non-white survivors generally had lower satisfaction, although results were mixed. Among breast and prostate cancer survivors, fee-for-services Medicare (vs. Medicare advantage) was associated with lower customer service satisfaction but higher satisfaction with getting prescription drugs. Breast cancer patients diagnosed with stage 3 disease reported greater satisfaction than did those diagnosed at stage 1. Conclusions: Factors associated with health care satisfaction ratings for cancer survivors showed substantial variations by cancer types. Programs to improve survivorship care and outcomes need to be tailored to survivors’ clinical and sociodemographic characteristics.