Evidence map›Paper›PMID 38408291›Full record

ArticleJCO oncology practice2024

Practice Consolidation Among US Medical Oncologists, 2015-2022.

Michael Milligan, Parsa Erfani, E John Orav, Stephen Schleicher, Gabriel A Brooks, Miranda B Lam

Abstract read
In one paragraph

Article in JCO oncology practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michael MilliganHarvard Radiation Oncology Program, Boston, MA.
Parsa ErfaniDepartment of Medicine, Brigham and Women's Hospital, Boston, MA.ORCID 0000-0002-5738-0556
E John OravDepartment of Medicine, Brigham and Women's Hospital, Boston, MA.
Stephen SchleicherTennessee Oncology, Lebanon, TN.
Gabriel A BrooksDartmouth Cancer Center, Lebanon, NH.ORCID 0000-0003-3984-9995
Miranda B LamDepartment of Radiation Oncology, Brigham and Women's Hospital, Boston, MA.ORCID 0000-0001-7885-6317

Funding

Assessing Variation in Outcomes for Cancer Patients Receiving Radiation Treatments and Identifying High-Value Radiation Oncology PracticesK08CA273549 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI Miranda Lam · 2023 to 2026
$1.1M
NCI NIH HHS K08 CA273549
6 · The paper itself

Abstract

purposeHealth care consolidation has significantly affected cancer care delivery, with oncology practices undergoing substantial consolidation over the past two decades. This study investigates practice consolidation trends among medical oncologists (MOs), factors associated with consolidation, and changes in MO geographic distribution.

methodsMedicare data from 2015 to 2022 were used to assess MO practice consolidation in hospital referral regions (HRRs), linked with regional health care market data and physician demographics. The Herfindahl-Hirschman Index (HHI) was used to measure consolidation, and the Gini coefficient was used to measure MO distribution across counties. Multivariable linear regression explored factors associated with MO practice consolidation.

resultsBetween 2015 and 2022, the number of MOs increased by 14.5% (11,727-13,433), whereas the number of MO practices decreased by 18.0% (2,774-2,276). The mean number of MOs per practice increased by 40% (4.26-5.95;

conclusionOn the basis of Federal Trade Commission classifications, MO practices were highly concentrated in 2015 and consolidated even further by 2022. While distribution of MOs at the county level remained stable, further research is needed to assess the effects of rapid consolidation on cancer care cost, quality, and access. These data have important implications for policymakers and payers as they design programs that ensure high-quality, affordable cancer care.

Indexed as

OncologistsHumansMaleMedical OncologyMedicareUnited States

Identifiers

PMID38408291
PMCPMC11608122

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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.