Follow-up care delivery among colorectal cancer survivors most often seen by primary and subspecialty care physicians.
BACKGROUND
The Institute of Medicine has identified patients as a key source of information for assessing the quality of care.


OBJECTIVE
To evaluate the association of physician specialty with the content and quality of follow-up cancer care.


METHODS
Three hundred three colorectal cancer (CRC) survivors in Northern California were surveyed 2-5 years post-diagnosis.


METHODS
Specialty of physician seen most often [primary care physician (PCP), oncologist, surgeon, or gastroenterologist]; other physician specialties seen; patient characteristics; content of visits; patient-centered quality of follow-up care (communication, coordination, nursing, and staff interactions).


RESULTS
A minority (16%) of CRC survivors reported that the doctor they most often saw for follow-up cancer care was a PCP, while 60% saw an oncologist. Many CRC survivors (40%) saw >1 physician for follow-up cancer care. Survivors most often seen by PCPs were more likely to have three or more medical comorbidities (70% vs. 51%, p = 0.012) than survivors seen by subspecialty physicians. Survivors seen by PCPs were less likely to report seeing a doctor for medical tests and more likely to report discussing disease prevention (82% vs. 64%, p = 0.012) or diet (70% vs. 48%, p = 0.005) with their doctor. There were no significant specialty differences in patient-centered quality of follow-up cancer care.


CONCLUSIONS
Cancer survivors' assessment of the quality of care was similar across specialties, while the content of follow-up cancer care varied by physician specialty. These findings provide important information about the potential value of primary care and the need for coordination when delivering care to CRC survivors.
Haggstrom
David A
DA
VA Health Services Research & Development (HSR&D) Center on Implementing Evidence-based Practice (CIEBP), Richard L. Roudebush VA Medical Center, 1481 West 10th St. (11H), Indianapolis, IN 46202, USA. dahaggst@iupui.edu
Arora
Neeraj K
NK
Helft
Paul
P
Clayman
Marla L
ML
Oakley-Girvan
Ingrid
I
D000368:Aged; D015179:Colorectal Neoplasms / Q000191:economics / Q000628:therapy*; D003266:Continuity of Patient Care / Q000191:economics / Q000639:trends; D003695:Delivery of Health Care / Q000191:economics / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008511:Medicine / Q000379:methods / Q000639:trends*; D008875:Middle Aged; D010820:Physicians / Q000191:economics / Q000639:trends; D010821:Physicians, Family / Q000191:economics / Q000639:trends*; D011159:Population Surveillance / Q000379:methods; D017741:Survivors