title: Predictors of Health Care Use of Women with Breast Cancer: A Systematic Review.
abstract: The aim of this study was to identify predictors of health care use among women with breast cancer by conducting a systematic review. Potentially relevant studies were identified by searching the PubMed, EMBASE, PsycINFO, CINAHL, and Cochrane Library databases. Also, backward and forward citation searches were performed. Studies were selected if they addressed associations between (a) sociodemographic, enabling (e.g., income), clinical and health related, or psychosocial predictors, and (b) medical, psychosocial, or paramedical health care use of adult women with breast cancer. The health care types of interest were hospital utilization and provider visits. An evaluation of aggregated findings was performed to determine consistency of findings between studies. Sixteen studies were included in the review. Higher age, a more advanced cancer stage, more comorbid disorders, having a mastectomy, a lymph node dissection, and breast reconstruction were consistently associated with higher hospital utilization. None of the patient characteristics were consistently associated with medical, psychosocial, or paramedical health care use-but psychosocial or paramedical associations were also less examined. In conclusion, sociodemographic, medical, and treatment-related factors were consistently associated with (higher) health care use of breast cancer patients. Practitioners may use this information to anticipate future use of subgroups of patients. Results may also be used in the development of interventions that target relevant predictors, to reduce patients' health care use and accompanying health care costs. Furthermore, more research is needed to identify predictors of psychosocial and paramedical health care use.
authors.affiliation: Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Deborah N N
authors.identifier: http://orcid.org/0000-0002-4950-7844
authors.initials: DN
authors.lastname: Lo-Fo-Wong
authors.affiliation: Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Kate
authors.initials: K
authors.lastname: Sitnikova
authors.affiliation: Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Mirjam A G
authors.initials: MA
authors.lastname: Sprangers
authors.affiliation: Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Hanneke C J M
authors.initials: HC
authors.lastname: de Haes
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy*; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D016387:Women's Health
keywords: breast cancer; health care use; systematic review