TY - JOUR
T1 - Variation in the Types of Providers Participating in Breast Cancer Follow-Up Care
T2 - A SEER-Medicare Analysis
AU - Neuman, Heather B.
AU - Schumacher, Jessica R.
AU - Schneider, David F.
AU - Winslow, Emily R.
AU - Busch, Rebecca A.
AU - Tucholka, Jennifer L.
AU - Smith, Maureen A.
AU - Greenberg, Caprice C.
N1 - Funding Information:
This project was funded through the University of Wisconsin Carbone Comprehensive Cancer Center (UWCCC) Academic Oncologist Training Program (NIH 5K12CA087718) and the Building Interdisciplinary Research Careers in Women’s Health Scholar Program (NIH K12 HD055894). Further funding came from contract no. (HHSA290201000006I) from the Agency for Healthcare Research and Quality (AHRQ) as part of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program. Finally, funding support for the SEER-Medicare group came from Grant no. (P30 CA014520) from the National Cancer Institute, the Health Innovation Program, the Community-Academic Partnerships and Biostatistics cores of the University of Wisconsin Institute for Clinical and Translational Research (Grant no. UL1TR0000427 from the Clinical and Translational Science Award program of the National Center for Research Resources, NIH National Center for Advancing Translational Sciences [NCATS]), and the UW School of Medicine and Public Health from The Wisconsin Partnership Program.
Publisher Copyright:
© 2016, Society of Surgical Oncology.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background: The current guidelines do not delineate the types of providers that should participate in early breast cancer follow-up care (within 3 years after completion of treatment). This study aimed to describe the types of providers participating in early follow-up care of older breast cancer survivors and to identify factors associated with receipt of follow-up care from different types of providers. Methods: Stages 1–3 breast cancer survivors treated from 2000 to 2007 were identified in the Surveillance, Epidemiology and End results Medicare database (n = 44,306). Oncologist (including medical, radiation, and surgical) follow-up and primary care visits were defined using Medicare specialty provider codes and linked American Medical Association (AMA) Masterfile. The types of providers involved in follow-up care were summarized. Stepped regression models identified factors associated with receipt of medical oncology follow-up care and factors associated with receipt of medical oncology care alone versus combination oncology follow-up care. Results: Oncology follow-up care was provided for 80 % of the patients: 80 % with a medical oncologist, 46 % with a surgeon, and 39 % with a radiation oncologist after radiation treatment. The patients with larger tumor size, positive axillary nodes, estrogen receptor (ER)-positive status, and chemotherapy treatment were more likely to have medical oncology follow-up care than older patients with higher Charlson comorbidity scores who were not receiving axillary care. The only factor associated with increased likelihood of follow-up care with a combination of oncology providers was regular primary care visits (>2 visits/year). Conclusions: Substantial variation exists in the types of providers that participate in breast cancer follow-up care. Improved guidance for the types of providers involved and delineation of providers’ responsibilities during follow-up care could lead to improved efficiency and quality of care.
AB - Background: The current guidelines do not delineate the types of providers that should participate in early breast cancer follow-up care (within 3 years after completion of treatment). This study aimed to describe the types of providers participating in early follow-up care of older breast cancer survivors and to identify factors associated with receipt of follow-up care from different types of providers. Methods: Stages 1–3 breast cancer survivors treated from 2000 to 2007 were identified in the Surveillance, Epidemiology and End results Medicare database (n = 44,306). Oncologist (including medical, radiation, and surgical) follow-up and primary care visits were defined using Medicare specialty provider codes and linked American Medical Association (AMA) Masterfile. The types of providers involved in follow-up care were summarized. Stepped regression models identified factors associated with receipt of medical oncology follow-up care and factors associated with receipt of medical oncology care alone versus combination oncology follow-up care. Results: Oncology follow-up care was provided for 80 % of the patients: 80 % with a medical oncologist, 46 % with a surgeon, and 39 % with a radiation oncologist after radiation treatment. The patients with larger tumor size, positive axillary nodes, estrogen receptor (ER)-positive status, and chemotherapy treatment were more likely to have medical oncology follow-up care than older patients with higher Charlson comorbidity scores who were not receiving axillary care. The only factor associated with increased likelihood of follow-up care with a combination of oncology providers was regular primary care visits (>2 visits/year). Conclusions: Substantial variation exists in the types of providers that participate in breast cancer follow-up care. Improved guidance for the types of providers involved and delineation of providers’ responsibilities during follow-up care could lead to improved efficiency and quality of care.
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U2 - 10.1245/s10434-016-5611-7
DO - 10.1245/s10434-016-5611-7
M3 - Article
C2 - 27709403
AN - SCOPUS:84990829240
SN - 1068-9265
VL - 24
SP - 683
EP - 691
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 3
ER -
