title: Meeting patients' health information needs in breast cancer center hospitals - a multilevel analysis.
abstract: BACKGROUND
  Breast cancer patients are confronted with a serious diagnosis that requires them to make important decisions throughout the journey of the disease. For these decisions to be made it is critical that the patients be well informed. Previous studies have been consistent in their findings that breast cancer patients have a high need for information on a wide range of topics. This paper investigates (1) how many patients feel they have unmet information needs after initial surgery, (2) whether the proportion of patients with unmet information needs varies between hospitals where they were treated and (3) whether differences between the hospitals account for some of these variation.
  
  
  METHODS
  Data from 5,024 newly-diagnosed breast cancer patients treated in 111 breast center hospitals in Germany were analyzed and combined with data on hospital characteristics. Multilevel linear regression models were calculated taking into account hospital characteristics and adjusting for patient case mix.
  
  
  RESULTS
  Younger patients, those receiving mastectomy, having statutory health insurance, not living with a partner and having a foreign native language report higher unmet information needs. The data demonstrate small between-hospital variation in unmet information needs. In hospitals that provide patient-specific information material and that offer health fairs as well as those that are non-teaching or have lower patient-volume, patients are less likely to report unmet information needs.
  
  
  CONCLUSIONS
  We found differences in proportions of patients with unmet information needs between hospitals and that hospitals' structure and process-related attributes of the hospitals were associated with these differences to some extent. Hospitals may contribute to reducing the patients' information needs by means that are not necessarily resource-intensive.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kowalski
authors.forename: Shoou-Yih D
authors.initials: SY
authors.lastname: Lee
authors.forename: Lena
authors.initials: L
authors.lastname: Ansmann
authors.forename: Simone
authors.initials: S
authors.lastname: Wesselmann
authors.forename: Holger
authors.initials: H
authors.lastname: Pfaff
mesh_terms: D022126:Access to Information; D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis; D002173:Cancer Care Facilities; D004644:Emotions; D005260:Female; D005858:Germany; D006761:Hospitals; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D055361:Multilevel Analysis; D020380:Needs Assessment; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires; D055815:Young Adult