Effect of model of care delivery on mammography use among elderly breast cancer survivors.
BACKGROUND
Despite gaps in the quality of follow-up care for breast cancer survivors, the most effective model for such care remains unclear. We evaluated receipt of mammography among survivors followed by generalist physicians, specialists, or both (referred to as 'shared care').


METHODS
We used Surveillance, Epidemiology, and End Results tumor registry data and Medicare claims to study 3828 older women, diagnosed with breast cancer in 1995.


RESULTS
During the first 3 years after treatment, about two-thirds of patients underwent shared care. Use of mammography in such patients was 84.0, 81.0 and 78.6% in follow-up years 1-3 respectively. For patients not using shared care, use of mammography was 76.3, 70.5, 66.0% in years 1-3 respectively. In a multivariate logistic regression model, women receiving shared care had substantially greater mammography use than others, with an odds ratio of 2.13 (95% CI: 1.74, 2.58) in the first follow-up year and similar odds ratios in subsequent follow-up years.


CONCLUSIONS
Most older breast cancer survivors undergo shared care. These patients receive better quality of care as measured by follow-up mammography.
Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Ann Eka-Ete P
AE
Etim
Kenneth G
KG
Schellhase
Rodney
R
Sparapani
Ann B
AB
Nattinger
D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality; D003695:Delivery of Health Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D018426:SEER Program; D017741:Survivors