title: Factors influencing mammogram ordering at the time of the office visit.
abstract: BACKGROUND
  Breast cancer is the second most common cause of cancer death in women, with mammographic screening the only modality shown to decrease the death rate. However, only 17% to 41% of women have ever been screened, and multiple barriers to screening have been identified. This study examined physician and patient factors at a single encounter to explore components influencing mammography ordering.
  
  
  METHODS
  Ten family physicians in a primary care research network completed daily data cards on encounters with women presenting for annual examinations, chronic problems, or breast-related complaints. Information collected included patient age, personal or family history of breast cancer, physician's perception of expected compliance, previous mammogram results, breast examination, physician's perception of need for a mammogram, whether the mammogram was ordered, and the patient's method of payment for the test.
  
  
  RESULTS
  Eight hundred thirty-nine patients were entered into the study, and 277 mammograms were ordered. Mammograms were ordered for a greater percentage of patients with insurance (36%) than for those without insurance (26%) (P < .001). A multivariate analysis indicated that several factors helped to correctly classify 90% of mammogram ordering: the patient was making a first visit, a breast-related visit, or a visit for an annual examination; the patient had had a previous mammogram; had a breast examination at the current visit or within the past year; and the physician believed the patient would comply and believed that a mammogram was indicated.
  
  
  CONCLUSIONS
  Factors unique to a physician-patient visit influence the physician with regard to ordering a mammogram, including the type of visit, whether the physician believes a mammogram is indicated, and the cost.
authors.affiliation: Department of Family Medicine, University of Colorado, Denver.
authors.forename: C M
authors.initials: CM
authors.lastname: Conry
authors.forename: D S
authors.initials: DS
authors.lastname: Main
authors.forename: R S
authors.initials: RS
authors.lastname: Miller
authors.forename: D C
authors.initials: DC
authors.lastname: Iverson
authors.forename: B N
authors.initials: BN
authors.lastname: Calonge
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003120:Colorado; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D009819:Office Visits; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012044:Regression Analysis