Geospatial disparities, health system factors, and breast cancer care quality
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View abstract on PubMed
Summary
This summary is machine-generated.Geospatial disparities in breast cancer care are minimal, with health system factors significantly influencing treatment quality. Optimal care involves multidisciplinary teams and well-resourced facilities.
Area Of Science
- Oncology
- Health Services Research
- Geospatial Epidemiology
Background
- Persistent quality gaps in breast cancer care necessitate identifying performance disparities.
- Understanding health-system and health-profession factors linked to geospatial variations is crucial for improvement.
Purpose Of The Study
- To identify regions with suboptimal breast cancer care performance.
- To characterize health-system and health-profession factors associated with geospatial disparities in breast cancer care quality.
Main Methods
- Utilized Surveillance, Epidemiology, and End Results-Medicare data (2007-2013) for 31,571 women (aged 66-79) with stage I-III breast cancer.
- Employed principal component analysis and hierarchical multivariable modeling to assess performance metrics (stage, chemotherapy, radiation, endocrine therapy) and attribute variance to patient, regional, and facility/provider factors.
Main Results
- Health system factors explained significant variance in endocrine therapy (21%), chemotherapy (12%), and radiation therapy (12%).
- Health profession and facility factors were associated with quality for stage, radiation, and chemotherapy.
- Patient characteristics explained less than 5% of the observed variance in breast cancer care quality.
Conclusions
- Suboptimal breast cancer care was identified in a small number of regions.
- Optimal performance is linked to multidisciplinary teams, robust resources, and higher facility volumes.
- Integrating geospatial and health system data can enhance quality improvement programs for breast cancer care.
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