서브메뉴
검색
Access to Allogeneic Hematopoietic Cell Transplant
Access to Allogeneic Hematopoietic Cell Transplant
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202103536
- ISBN
- 9798315752837
- DDC
- 614
- 서명/저자
- Access to Allogeneic Hematopoietic Cell Transplant
- 발행사항
- [Sl] : The University of Wisconsin - Madison, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 132 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 86-11, Section: B.
- 주기사항
- Advisor: Burns, Marguerite E.
- 학위논문주기
- Thesis (Ph.D.)--The University of Wisconsin - Madison, 2025.
- 초록/해제
- 요약Background: Allogeneic hematopoietic cell transplantation (alloHCT) is a potentially curative treatment for patients diagnosed with blood cancers like acute myeloid leukemia (AML). Although increased diversity of unrelated donors and improvements in conditioning regimens and supportive care have led to an increase in the number of alloHCTs performed over time, barriers such as age-related disparities in receipt of treatment for AML persist, and transplant center (TC) caregiver requirements can limit access to alloHCT.Methods: For Aims 1 and 2, a retrospective cohort study using Medicare administrative claims data linked with NMDP donor search and publicly available data was used. In Aim 1, a descriptive analysis to assess treatment pathways and receipt of recommended services was conducted. In Aim 2, a hierarchical logistic regression was used to assess patient, physician, and hospital factors associated with the treatment pathways. For Aim 3, a qualitative analysis was conducted with United States TC social workers to determine caregiver requirements. Results: Findings from Aim 1 showed that over time, the proportion of patients receiving alloHCT, chemotherapy with a donor search, and no therapy increased, with a concomitant decrease in the proportion of patients not having a donor search performed. While patients in all treatment pathways received recommended services, utilization differed across the pathways. Findings from Aim 2 showed that patient characteristics, such as age and comorbidity index, were associated with receipt of alloHCT when compared to chemotherapy with and without donor search, and with receipt of chemotherapy with donor search when compared to chemotherapy without donor search. Patient, hospital and physician factors were associated with receipt of alloHCT when compared with no therapy. Aim 3 results showed variation in caregiver requirements, enforcement of those requirements, and found that the lack of a caregiver can prevent patients from receiving an alloHCT.Conclusions: Aims 1 and 2 showed that multiple factors can influence access to alloHCT for patients with AML, including patient, physician, and hospital characteristics and an opportunity exists to enhance timely receipt of recommended services for optimal patient outcomes. In Aim 3, the variation in requirements, both across and within TCs, suggests that there is a lack of evidence informing caregiver requirements. Interventions focused on timely referral for alloHCT, education for physicians who refer patients to TCs, timely donor search, early identification of patient barriers, and appropriate referral to resources may help alleviate barriers and improve patients access to care. Additionally, innovative and patient-centered models and approaches are needed to ensure that patients can access the treatment they need, regardless of whether they have a caregiver.
- 일반주제명
- Health sciences
- 일반주제명
- Oncology
- 일반주제명
- Cellular biology
- 일반주제명
- Biomedical engineering
- 일반주제명
- Bioinformatics
- 키워드
- Caregiver
- 기타저자
- The University of Wisconsin - Madison Population Health
- 기본자료저록
- Dissertations Abstracts International. 86-11B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
008260126s2025 us c eng d■001000017357609
■00520260202103536
■006m o d
■007cr#unu||||||||
■020 ▼a9798315752837
■035 ▼a(MiAaPQ)AAI32040475
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614
■1001 ▼aPreussler, Jaime M.
■24510▼aAccess to Allogeneic Hematopoietic Cell Transplant
■260 ▼a[Sl]▼bThe University of Wisconsin - Madison▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a132 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 86-11, Section: B.
■500 ▼aAdvisor: Burns, Marguerite E.
■5021 ▼aThesis (Ph.D.)--The University of Wisconsin - Madison, 2025.
■520 ▼aBackground: Allogeneic hematopoietic cell transplantation (alloHCT) is a potentially curative treatment for patients diagnosed with blood cancers like acute myeloid leukemia (AML). Although increased diversity of unrelated donors and improvements in conditioning regimens and supportive care have led to an increase in the number of alloHCTs performed over time, barriers such as age-related disparities in receipt of treatment for AML persist, and transplant center (TC) caregiver requirements can limit access to alloHCT.Methods: For Aims 1 and 2, a retrospective cohort study using Medicare administrative claims data linked with NMDP donor search and publicly available data was used. In Aim 1, a descriptive analysis to assess treatment pathways and receipt of recommended services was conducted. In Aim 2, a hierarchical logistic regression was used to assess patient, physician, and hospital factors associated with the treatment pathways. For Aim 3, a qualitative analysis was conducted with United States TC social workers to determine caregiver requirements. Results: Findings from Aim 1 showed that over time, the proportion of patients receiving alloHCT, chemotherapy with a donor search, and no therapy increased, with a concomitant decrease in the proportion of patients not having a donor search performed. While patients in all treatment pathways received recommended services, utilization differed across the pathways. Findings from Aim 2 showed that patient characteristics, such as age and comorbidity index, were associated with receipt of alloHCT when compared to chemotherapy with and without donor search, and with receipt of chemotherapy with donor search when compared to chemotherapy without donor search. Patient, hospital and physician factors were associated with receipt of alloHCT when compared with no therapy. Aim 3 results showed variation in caregiver requirements, enforcement of those requirements, and found that the lack of a caregiver can prevent patients from receiving an alloHCT.Conclusions: Aims 1 and 2 showed that multiple factors can influence access to alloHCT for patients with AML, including patient, physician, and hospital characteristics and an opportunity exists to enhance timely receipt of recommended services for optimal patient outcomes. In Aim 3, the variation in requirements, both across and within TCs, suggests that there is a lack of evidence informing caregiver requirements. Interventions focused on timely referral for alloHCT, education for physicians who refer patients to TCs, timely donor search, early identification of patient barriers, and appropriate referral to resources may help alleviate barriers and improve patients access to care. Additionally, innovative and patient-centered models and approaches are needed to ensure that patients can access the treatment they need, regardless of whether they have a caregiver.
■590 ▼aSchool code: 0262.
■650 4▼aHealth sciences
■650 4▼aOncology
■650 4▼aCellular biology
■650 4▼aBiomedical engineering
■650 4▼aBioinformatics
■653 ▼aBone marrow transplant
■653 ▼aCaregiver
■653 ▼aQualitative research
■653 ▼aQuantitative research
■653 ▼aTreatment pathway
■690 ▼a0566
■690 ▼a0992
■690 ▼a0379
■690 ▼a0541
■690 ▼a0715
■71020▼aThe University of Wisconsin - Madison▼bPopulation Health.
■7730 ▼tDissertations Abstracts International▼g86-11B.
■790 ▼a0262
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357609▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
