title: Perceptions of care coordination in a population-based sample of diverse breast cancer patients.
abstract: OBJECTIVE
  To identify factors associated with perceptions of care coordination in a diverse sample of breast cancer patients.
  
  
  METHODS
  Breast cancer patients reported to the metropolitan SEER registries of Detroit or Los Angeles from 6/05 to 2/07 were surveyed after diagnosis (N=2268, RR=72.4%). Outcomes were two dichotomous measures reflecting patient appraisal of care coordination during their treatment experience. Primary independent variables were race/ethnicity (white, African American, Latina-high acculturated, Latina-low acculturated) and health literacy (low, moderate, high). Logistic regression was used to evaluate factors associated with both measures of care coordination.
  
  
  RESULTS
  2148 subjects were included in the analytic dataset. 16.4% of women perceived low care coordination and 12.5% reported low satisfaction. Race/ethnicity was not significantly associated with care coordination. Women with low subjective health literacy were 3-4 times as likely as those with high health literacy to perceive low care coordination and low satisfaction with care coordination (OR=3.88; 95% CI: 2.78-5.41; OR=3.19 95% CI: 2.25-4.52, respectively).
  
  
  CONCLUSIONS
  Many breast cancer patients positively appraised their care coordination, but patients with low health literacy perceived low care coordination.
  
  
  CONCLUSIONS
  Providers should be aware of the health literacy deficits that may contribute to their patients' attitudes towards their breast cancer care coordination.
authors.affiliation: Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109-0429, USA. sarahawl@med.umich.edu
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Janz
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Lillie
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Friese
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Griggs
authors.forename: John J
authors.initials: JJ
authors.lastname: Graff
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
authors.forename: Sarika
authors.initials: S
authors.lastname: Jain
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Katz
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*; D003266:Continuity of Patient Care; D003695:Delivery of Health Care / Q000458:organization & administration*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D057220:Health Literacy; D006801:Humans; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D011787:Quality of Health Care; D018426:SEER Program; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult