Integrated Care Addresses Racial Gaps

A new study by Stanford University researchers strongly suggests that a holistic integrated care model can overcome significant ethnic disparities in treating colon cancer patients.

The study, which examined 30,000 colon cancer patients in California, concluded that there was no differences in mortality rates when care delivered within an integrated care model, such as what is provided by Oakland-based Kaiser Permanente. But outside of that model, African-Americans had an approximately 15% higher mortality rate when compared to other ethnic groups.

African-Americans already have a higher susceptibility to colon cancer than other ethnic groups, with the disease afflicting nearly 60 per 100,000 in the U.S., compared to 48.6 per 100,000 among whites, according to data from the National Cancer Institute.

The overall mortality rates are about 40% higher as well, at about 25.4 per 100,000 among blacks compared to 17.7 per 100,000 among whites. Policy experts have suggested that the lower socioeconomic status of many African-Americans means they may lack insurance for regular screenings and therefore receive diagnoses in the later stages of the disease that translate to higher mortality rates. 

The five-year survival rate for colon cancer patients when their disease is diagnosed in the earliest stages tops 90%, but it drops below 70% in the intermediate stages.

The integrated “approach to care is associated with higher levels of evidence-based medicine, improved survival and reduced colon cancer disparity gaps (and) may represent an important model for improving cancer outcomes and addressing disparities. ” wrote the study's authors. 

The integrated healthcare system therefore “may represent an important model for improving cancer outcomes and addressing disparities,” according to the study. 

Among the Kaiser patients studied, there was no disparity in the mortality rates between African-Americans and patients from other ethnic groups.

“This study highlights the results of one of the key areas of focus for Kaiser Permanente leadership — our commitment to excellence and equity,” said Ronald Copeland, M.D., Kaiser Permanente chief diversity and inclusion officer. “Through Kaiser Permanente’s integrated healthcare model, our evidence-based group practices, and the deployment of culturally and linguistically adapted, patient-centric engagement strategies that inform health screening techniques we ensure that all of our patients receive the best care possible.” 

The study was published in the most recent issue of the journal Clinical Oncology.