title: Improving access to breast health services with an interdisciplinary model of care.
abstract: This article reports a hospital's experience confronting a community crisis, stemming from local and national breast health access issues, and evaluates the subsequent effectiveness of the initiative to improve breast care service. An interdisciplinary Breast Care Facility was developed adjacent to a Community Hospital. Patients receiving breast cancer screening during the year prior to the Breast Center opening (2002) were compared with patients in subsequent years (2003-2005). Program effectiveness was evaluated by examining screening mammography volume, wait times and cancer detection rates. Screening volume increased by 29.6%. Wait times declined from 30 weeks to 3.5 weeks. Initially, patients with a suspicious screening mammography had a 2-3 week delay for diagnostic mammography and the subsequent evaluation took another 3-4 weeks. Both times improved to an average of 2-5 days. Screening cancer detection rates increased from 3.2 per 1,000, to 6.3 per 1,000. In addition, the number of cancers identified by screening increased from 40% to 58%, p = 0.002. Patient satisfaction measured by survey was over 95%, in areas of courtesy, counseling, and overall care. Our study demonstrates that a comprehensive breast center model can increase access to breast care services, improve patient satisfaction and address focal areas of shortage. Furthermore, in the years after the opening of the breast center the cancer detection rate during screening increased, an important observation that needs to be investigated with future studies.
authors.affiliation: Medical Woman's Health Division, Department of Medicine, Staten Island University Hospital, Staten Island, New York 10305, USA. mcastellanos@siuh.edu
authors.forename: Mario R
authors.initials: MR
authors.lastname: Castellanos
authors.forename: Joseph
authors.initials: J
authors.lastname: Conte
authors.forename: Dina Abi
authors.initials: DA
authors.lastname: Fadel
authors.forename: Carolyn
authors.initials: C
authors.lastname: Raia
authors.forename: Frank
authors.initials: F
authors.lastname: Forte
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ahern
authors.forename: Marianne
authors.initials: M
authors.lastname: Smith
authors.forename: Danny
authors.initials: D
authors.lastname: Elsayeh
authors.forename: Shalom
authors.initials: S
authors.lastname: Buchbinder
mesh_terms: D001706:Biopsy / Q000706:statistics & numerical data; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data; D017146:Models, Organizational; D009518:New York; D017060:Patient Satisfaction; D013997:Time Factors