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Percent of Cancer Patients Seeing 10 or More Different Physicians during the Last Six Months of Life
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    Region
    (Click a region name
    below to view its profile)
    Percent of Cancer Patients Seeing 10 or More Different Physicians during the Last Six Months of Life
    (Year: 2012; Region Levels: State)
    Wyoming 40.8%
    Wisconsin 52.4%
    West Virginia 51.8%
    Washington 54.1%
    Virginia 66.4%
    Vermont 50.5%
    Utah 45.2%
    Texas 58.3%
    Tennessee 58.0%
    South Dakota 49.1%
    South Carolina 57.1%
    Rhode Island 65.7%
    Pennsylvania 69.8%
    Oregon 41.1%
    Oklahoma 45.1%
    Ohio 62.2%
    North Dakota 49.3%
    North Carolina 60.6%
    New York 71.9%
    New Mexico 48.8%
    New Jersey 75.5%
    New Hampshire 61.1%
    Nevada 64.5%
    Nebraska 52.8%
    Montana 37.4%
    Missouri 52.9%
    Mississippi 51.9%
    Minnesota 53.6%
    Michigan 65.3%
    Massachusetts 70.4%
    Maryland 68.2%
    Maine 53.3%
    Louisiana 54.0%
    Kentucky 54.2%
    Kansas 46.7%
    Iowa 48.6%
    Indiana 55.7%
    Illinois 62.4%
    Idaho 37.2%
    Hawaii 51.6%
    Georgia 59.0%
    Florida 69.5%
    District of Columbia 65.1%
    Delaware 69.2%
    Connecticut 75.0%
    Colorado 56.4%
    California 59.7%
    Arkansas 45.1%
    Arizona 67.5%
    Alaska 49.1%
    Alabama 52.5%
    National Average 61.7%
    90th Percentile 69.8%
    50th Percentile 54.2%
    10th Percentile 45.1%
        • DENOMINATOR DEFINITION:
        • We identified a 20% sample of all Medicare beneficiaries who died between the ages of 66 and 99 years during the period 2003-07. Data for 2010-12 are based on a 100% sample of claims. We excluded beneficiaries without continuous Part A and Part B coverage in the last six months of life or who were enrolled in Medicare health maintenance organizations (i.e., Medicare Advantage). From these decedents, we identified those with poor prognosis cancer diagnoses on at least one hospital claim or at least two clinician visits in the last six months of life. We then categorized decedents into one of 26 cancer types based on their predominant cancer diagnosis using a modified Clinical Classification Software (CCS) approach; please see the Methods of our cancer report for details.

        • NUMERATOR DEFINITION:
        • Number of patients that saw 10 or more different physicians during the last six months of life. The number of physicians seen in the last six months of life is computed based on the Unique Provider Identification Number (UPIN) on the Part B claim.

        • ADJUSTMENTS:
        • Although all of these patients died of serious cancer, groups of patients across hospitals or regions may have differed by other characteristics such as the composition of age, sex or race. All rates are adjusted with the following patient level characteristics: age, race (black/non-black), sex, cancer type, and non-cancer chronic conditions.




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    The Dartmouth Atlas of Health Care is based at The Dartmouth Institute for Health Policy and Clinical Practice and is supported by a coalition of funders led by the Robert Wood Johnson Foundation, including the WellPoint Foundation, the United Health Foundation, the California HealthCare Foundation, and the Charles H. Hood Foundation.