{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T06:24:44Z","timestamp":1776407084710,"version":"3.51.2"},"reference-count":37,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2018,6,7]],"date-time":"2018-06-07T00:00:00Z","timestamp":1528329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Rural cancer patients often have challenges in accessing quality care. This study examined associations between the place of residence at cancer diagnosis (urban vs rural) and patient ratings of access to care among older cancer survivors participating in Medicare\u2010managed care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Using Surveillance, Epidemiology, and End Results \u2013Consumer Assessment of Healthcare Providers and Systems (SEER\u2010CAHPS) linked data, which included SEER data and Medicare CAHPS patient experience surveys, this study identified urban (n\u2009=\u20096140) and rural Medicare beneficiaries (n\u2009=\u2009686) aged\u2009\u2265\u200965 years with a breast, lung, colorectal, or prostate cancer diagnosis who had completed a Medicare CAHPS survey between 1998 and 2013. Multivariable models examined associations between survivor residence at the time of diagnosis and CAHPS measures of timeliness and ease of getting care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Respondents who resided in urban areas (vs rural) at the time of their cancer diagnosis rated their care significantly lower for Getting Care Quickly (\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u2009\u22122.27; standard error\u2009=\u20090.95;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.02). Although there were no overall significant differences for Getting Needed Care, there was a significant interaction between race\/ethnicity and residence (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.04): both non\u2010Hispanic black and Hispanic respondents residing in rural areas rated Getting Needed Care lower than those respondents residing in urban areas.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>\n                      In contrast to prior studies, these findings suggest that rural survivors report more timely care than those in urban areas, but accessing needed care may be more challenging for racial\/ethnic minority rural survivors. Future examination of specific barriers for urban and racial\/ethnic minority rural survivors is warranted to ensure equitable access to quality cancer care.\n                      <jats:bold>\n                        <jats:italic>Cancer<\/jats:italic>\n                        2018.\n                      <\/jats:bold>\n                      \u00a9\n                      <jats:italic>2018 American Cancer Society<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.31541","type":"journal-article","created":{"date-parts":[[2018,6,7]],"date-time":"2018-06-07T09:26:36Z","timestamp":1528363596000},"page":"3257-3265","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Examining urban and rural differences in perceived timeliness of care among cancer patients: A SEER\u2010CAHPS study"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8092-3013","authenticated-orcid":false,"given":"Michelle A.","family":"Mollica","sequence":"first","affiliation":[{"name":"Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences National Cancer Institute Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn E.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Social Sciences and Health Policy Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy S.","family":"McNeel","sequence":"additional","affiliation":[{"name":"Information Management Services, Inc Rockville Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin E.","family":"Kent","sequence":"additional","affiliation":[{"name":"Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences National Cancer Institute Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,7]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"118","volume-title":"Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care","author":"Smedley B","year":"2003"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.17226\/18359"},{"key":"e_1_2_8_4_1","volume-title":"Cancer Facts & Figures 2016","author":"American Cancer Society","year":"2016"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-13-0404"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27840"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-011-9439-6"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-17-0092"},{"key":"e_1_2_8_9_1","first-page":"991","article-title":"Distance to diagnosing provider as a measure of access for patients with melanoma","volume":"143","author":"Stitzenberg K","year":"2007","journal-title":"Arch Dermatol Res."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-013-0225-x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-011-1270-1"},{"key":"e_1_2_8_12_1","first-page":"633","article-title":"Challenges of rural cancer care in the United States","volume":"29","author":"Charlton M","year":"2015","journal-title":"Oncology (Williston Park)."},{"key":"e_1_2_8_13_1","first-page":"2324","article-title":"Comparing urban and rural young adult cancer survivors' experiences: a qualitative study","volume":"13","author":"Miedema B","year":"2013","journal-title":"Rural Remote Health."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-014-3162-9"},{"key":"e_1_2_8_15_1","first-page":"41","article-title":"Psychometric properties of an instrument to assess Medicare beneficiaries' prescription drug plan experiences","volume":"30","author":"Martino S","year":"2009","journal-title":"Health Care Financ Rev."},{"key":"e_1_2_8_16_1","unstructured":"USDA Economic Research Service.USDA rural\u2010urban continuum codes\u2014documentation.https:\/\/www.ers.usda.gov\/data-products\/rural-urban-continuum-codes\/. 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