Mammography facility characteristics and repeat mammography use among Medicare beneficiaries.
BACKGROUND
The goal of this study was to examine mammography facility characteristics and explore how such characteristics may impact repeat mammography use.


METHODS
Mammography facility characteristics were obtained through a mailed a 21-item survey to Kansas mammography facilities. Medicare mammography claims were used to calculate facility-specific repeat mammography rates. Administrative data included female Kansas beneficiaries aged 65 years and older (N = 39,035) with a baseline mammogram during 1999. Beneficiaries with a mammography claim 12-18 months after their baseline mammogram were deemed to have had a repeat mammogram.


RESULTS
Completed surveys were received from 90% (N = 79) of the 97 facilities serving >10 beneficiaries. Most facilities were in rural communities (58%), had an on-site radiologist (58%), and mailed mammography reminders to patients (63%). Extended hours of operation and the acceptance of self-referrals were uncommon (33% and 37%, respectively). Few facilities employed a quality improvement team (33%) or measured annual patient return rates (18%), but many measured patient satisfaction (57%). Of the beneficiaries, 61% had a repeat mammogram during the subsequent 12-18 months (range, 0% to 84%). Facilities notifying primary care providers of patients due for mammograms had higher repeat mammography rates. Multiple regression analyses found that higher repeat mammography rates were associated with facilities that accepted self-referrals, measured patient satisfaction, were in urban areas, and served a larger proportion of white beneficiaries.


CONCLUSIONS
Mammography facility characteristics and repeat mammography rates vary widely. Although modifiable facility characteristics that may influence repeat mammography need additional study, results from this study indicate that mammography facilities are an opportunistic arena for quality improvement endeavors.
Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA. kengelma@kumc.edu
Kimberly K
KK
Engelman
Edward F
EF
Ellerbeck
Matthew S
MS
Mayo
Samuel J
SJ
Markello
Jasjit S
JS
Ahluwalia
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000517:prevention & control*; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007615:Kansas; D016015:Logistic Models; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000191:economics / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D009936:Organizational Innovation; D017060:Patient Satisfaction; D011336:Probability; D017010:Reminder Systems / Q000592:standards*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires