Evidence map›Paper›PMID 23269996›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2013

Medical oncologists' perceptions of financial incentives in cancer care.

Jennifer L Malin, Jane C Weeks, Arnold L Potosky, Mark C Hornbrook, Nancy L Keating

Open access · bronzeAbstract read
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
16.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 38 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Characterizing and assessing antiemetic underuse in patients initiating highly emetogenic chemotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2019
    Article
  7. Review
  8. Observational
  9. Article
  10. Reform of the Buy-and-Bill System for Outpatient Chemotherapy Care Is Inevitable: Perspectives from an Economist, a Realpolitik, and an Oncologist.American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting · 2015
    Article
  11. Article
  12. Article
  13. Patient and oncologist discussions about cancer care costs.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2014
    Article
  14. Rationing healthcare: who's responsible?Oncology (Williston Park, N.Y.) · 2013
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Jennifer L MalinWellPoint, 1 WellPoint Way, Thousand Oaks, CA 91362, USA. jennifer.malin@wellpoint.com
Jane C Weeks
Arnold L Potosky
Mark C Hornbrook
Nancy L Keating
Harvard University · USBrigham and Women's Hospital · USGeorgetown University Medical Center · USKaiser Permanente Center for Health Research · US

Funding

PROPENSITY SCORES IN HIERARCHICAL MODELSU01CA093344 · NCI · DANA-FARBER CANCER INSTITUTE · PI AYANIAN, JOHN Z., FOUAD, MONA N. · 2001 to 2011
$19.5M
Lung/Colon Cancer Outcomes--Cancer Research NetworkU01CA093332 · NCI · DANA-FARBER CANCER INSTITUTE · PI WEEKS, JANE C. · 2001 to 2008
$7.4M
RAND-UCLA CanCORS PDCR ApplicationU01CA093348 · NCI · RAND CORPORATION · PI KAHN, KATHERINE LESLIE · 2001 to 2008
$7.3M
Cancer Care Outcomes Research &Surveillance ConsortiumU01CA093324 · NCI · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI AYANIAN, JOHN Z. · 2001 to 2008
$7.1M
RACIAL DISPARITIES IN END OF LIFE CARE--ACCESSU01CA093329 · NCI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI FOUAD, MONA N. · 2001 to 2008
$6.6M
NC Colorectal Cancer Care Outcomes Research StudyU01CA093326 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SANDLER, ROBERT S. · 2001 to 2008
$4.3M
NCI NIH HHS U01 CA01013NCI NIH HHS U01 CA093324NCI NIH HHS U01 CA093326NCI NIH HHS U01 CA093329NCI NIH HHS U01 CA093332NCI NIH HHS U01 CA093344NCI NIH HHS U01 CA093348
6 · The paper itself

Abstract

purposeThe cost of cancer care continues to increase at an unprecedented rate. Concerns have been raised about financial incentives associated with the chemotherapy concession in oncology practices and their impact on treatment recommendations.

methodsThe objective of this study was to measure the physician-reported effects of prescribing chemotherapy or growth factors or making referrals to other cancer specialists, hospice, or hospital admissions on medical oncologists' income. US medical oncologists involved in the care of a population-based cohort of patients with lung or colorectal cancer from the Cancer Care Outcomes Research and Surveillance (CanCORS) study were surveyed regarding their perceptions of the impact of prescribing practices or referrals on their income.

resultsAlthough most oncologists reported that their incomes would be unaffected, compared with salaried oncologists, physicians in fee-for-service practice, and those paid a salary with productivity incentives were more likely to report that their income would increase from administering chemotherapy (odds ratios [ORs], 7.05 and 7.52, respectively; both P < .001) or administering growth factors (ORs, 5.60 and 6.03, respectively; both P < .001).

conclusionA substantial proportion of oncologists who are not paid a fixed salary report that their incomes increase when they administer chemotherapy and growth factors. Further research is needed to understand the impact of these financial incentives on both the quality and cost of care.

Indexed as

IncomeAdultAntineoplastic AgentsConfounding Factors, EpidemiologicDrug PrescriptionsFee-for-Service PlansFemaleHealth Care CostsHealth Care SurveysHospice CareHumansIntercellular Signaling Peptides and ProteinsMaleMedical OncologyMiddle AgedOdds RatioAntineoplastic AgentsIntercellular Signaling Peptides and Proteins

Identifiers

PMID23269996
PMCPMC3565179
OpenAlexW2170033310

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.