Concordance of Patient and Caregiver Reports on the Quality of Colorectal Cancer Care

Rachel D. Havyer, Michelle van Ryn, Patrick M. Wilson, Lauren R. Bangerter, Joan M. Griffin

Research output: Contribution to journalArticle

Abstract

PURPOSE: We aimed to better understand how similarly patients with colorectal cancer and caregivers view care quality and to assess factors that may influence concordance. MATERIALS AND METHODS: We conducted a secondary analysis of paired patient and caregiver quality ratings of colorectal cancer care in three specific domains: surgery, chemotherapy overall, and chemotherapy nursing. Agreement was assessed with difference scores, concordance with Gwet second-order agreement statistics (AC2), and variation in agreement with stratified analyses. We examined whether the care experiences of patients and caregivers were associated with top-box (most-positive) ratings and examined variations in concordance on the basis of the presence of a top-box score. RESULTS: Four hundred seventeen patient-caregiver dyads completed the surveys. Quality-of-care ratings were positively skewed, with most dyads indicating top-box ratings. Patient and caregiver care experiences were highly associated with top-box ratings. Overall patient-caregiver concordance was very high for all three care domains (surgery: AC2, 0.87 [95% CI, 0.83 to 0.90]; chemotherapy overall: AC2, 0.84 [95% CI, 0.79 to 0.88]; chemotherapy nursing: AC2, 0.91 [95% CI, 0.87 to 0.94]). Stratified analyses of patient and caregiver characteristics did not identify any patterns that consistently affected concordance. The concordance statistic significantly decreased for all three outcomes (P < .001), however, when the patient or caregiver assessed quality as anything other than top box. CONCLUSION: Caregiver and patient reports on care quality were highly concordant for top-box care and did not vary with patient or caregiver factors. Additional exploration is needed to identify reasons for increased variability when the quality scores were less than a top-box response.

Original languageEnglish (US)
Pages (from-to)e979-e988
JournalJournal of oncology practice
Volume15
Issue number11
DOIs
StatePublished - Nov 1 2019

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Caregivers
Colorectal Neoplasms
Quality of Health Care
Drug Therapy
Patient Care
Nursing

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy

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Concordance of Patient and Caregiver Reports on the Quality of Colorectal Cancer Care. / Havyer, Rachel D.; van Ryn, Michelle; Wilson, Patrick M.; Bangerter, Lauren R.; Griffin, Joan M.

In: Journal of oncology practice, Vol. 15, No. 11, 01.11.2019, p. e979-e988.

Research output: Contribution to journalArticle

Havyer, Rachel D. ; van Ryn, Michelle ; Wilson, Patrick M. ; Bangerter, Lauren R. ; Griffin, Joan M. / Concordance of Patient and Caregiver Reports on the Quality of Colorectal Cancer Care. In: Journal of oncology practice. 2019 ; Vol. 15, No. 11. pp. e979-e988.
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abstract = "PURPOSE: We aimed to better understand how similarly patients with colorectal cancer and caregivers view care quality and to assess factors that may influence concordance. MATERIALS AND METHODS: We conducted a secondary analysis of paired patient and caregiver quality ratings of colorectal cancer care in three specific domains: surgery, chemotherapy overall, and chemotherapy nursing. Agreement was assessed with difference scores, concordance with Gwet second-order agreement statistics (AC2), and variation in agreement with stratified analyses. We examined whether the care experiences of patients and caregivers were associated with top-box (most-positive) ratings and examined variations in concordance on the basis of the presence of a top-box score. RESULTS: Four hundred seventeen patient-caregiver dyads completed the surveys. Quality-of-care ratings were positively skewed, with most dyads indicating top-box ratings. Patient and caregiver care experiences were highly associated with top-box ratings. Overall patient-caregiver concordance was very high for all three care domains (surgery: AC2, 0.87 [95{\%} CI, 0.83 to 0.90]; chemotherapy overall: AC2, 0.84 [95{\%} CI, 0.79 to 0.88]; chemotherapy nursing: AC2, 0.91 [95{\%} CI, 0.87 to 0.94]). Stratified analyses of patient and caregiver characteristics did not identify any patterns that consistently affected concordance. The concordance statistic significantly decreased for all three outcomes (P < .001), however, when the patient or caregiver assessed quality as anything other than top box. CONCLUSION: Caregiver and patient reports on care quality were highly concordant for top-box care and did not vary with patient or caregiver factors. Additional exploration is needed to identify reasons for increased variability when the quality scores were less than a top-box response.",
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