Satisfaction with care among low-income women with breast cancer.
BACKGROUND
Patient satisfaction is an important outcome measure in determining quality of care. There are few data evaluating patient satisfaction in nonwhite, low-income populations. The objective of this study was to identify the structure, process, and outcome factors that impact patient satisfaction with care in a low-income population of women with breast cancer.


METHODS
In a cross-sectional survey of low-income women newly diagnosed with breast cancer, eligible women enrolled in the California Breast and Cervical Cancer Treatment Program (BCCTP) from February 2003 through September 2005 were interviewed by phone 6 months after their enrollment. This was a population-based sample of women aged >or=18 years (n = 924) with a definitive diagnosis of breast cancer and enrolled in the BCCTP. The main outcome measure was satisfaction with care received.


RESULTS
Random effects logistic regression revealed that less acculturated Latinas were more likely (odds ratio, [OR] = 5.36, p < 0.000) to be extremely satisfied with their care compared with non-Hispanic white women. Women who believed they could have been diagnosed sooner were less likely to be extremely satisfied (OR = 0.61, p < 0.000). Women who had received or were receiving radiotherapy or chemotherapy had nearly twice the odds of being extremely satisfied (OR = 2.02, p < 0.000, and OR = 2.13, p < 0.000, respectively). Greater information giving was associated with greater satisfaction (OR = 1.17, p < 0.000). Women reporting greater physician emotional support were more likely to report being extremely satisfied (OR = 1.26, p < 0.000). A higher participatory treatment decision-making score was associated with greater satisfaction (OR = 1.78, p < 0.000).


CONCLUSIONS
In a low-income population, satisfaction is also reported at high levels. In addition to age, ethnicity/acculturation, receipt of chemotherapy and radiotherapy, physician emotional support, and collaborative decision making, perception of diagnostic delay is a predictor of dissatisfaction in this population.
Thind
Amardeep
A
Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada. athind2@uwo.ca
Hoq
Lalima
L
Diamant
Allison
A
Maly
Rose C
RC
D000069:Acculturation; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health / Q000208:ethnology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D002140:California / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000208:ethnology / Q000706:statistics & numerical data*; D011203:Poverty / Q000208:ethnology / Q000523:psychology*; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult