Influence of provider and practice characteristics on melanoma care.
BACKGROUND
Melanoma care is becoming increasingly multidisciplinary, requiring coordination of many types of providers. The purpose of this study is to describe the structure of melanoma care in North Carolina by examining services provided by different providers and the overall coordination of care.


METHODS
Self-administered surveys were developed to collect demographic and practice information, assess patient volume and services provided, and explore referral patterns. Surveys were administered to all dermatologists and a subset of surgeons practicing in North Carolina.


RESULTS
The response rate was 60% (263/438). Melanoma patient volume, referral patterns, use of nodal staging, and access to clinical trials were each related to provider characteristics, specialty, affiliations with cancer care organizations, and practice setting.


CONCLUSIONS
Many types of providers contribute significantly to the care of melanoma patients. Coordination between providers is variable. This study provides indirect evidence that multidisciplinary melanoma programs increase patient access to comprehensive melanoma care.
Stitzenberg
Karyn B
KB
Department of Surgery, University of North Carolina, 3010 Old Clinic Building, CB# 7213, Chapel Hill, NC 27599-7213, USA. karyn_stitzenberg@unc.edu
Thomas
Nancy E
NE
Ollila
David W
DW
D000328:Adult; D002986:Clinical Trials as Topic; D003880:Dermatology / Q000706:statistics & numerical data*; D005260:Female; D013502:General Surgery / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009367:Neoplasm Staging; D009657:North Carolina / Q000453:epidemiology; D010348:Patient Care Team; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology*