breast cancer;
triage;
access;
referrals;
health care systems;
barriers;
D O I:
10.1016/j.amjsurg.2007.06.014
中图分类号:
R61 [外科手术学];
学科分类号:
摘要:
Objective: Minority patients are at risk for delayed breast cancer treatment. Using nonsurgical breast specialists could improve access but requires appropriate referral to ensure prompt cancer care. Our objective was to evaluate a referral triage system in a combined medical/surgical breast health program (BHP). Methods: A triage system based on imaging findings, examination, and patient age was instituted. An advanced practice nurse managed referrals and a prospective database. Referring providers were surveyed after 2 years. Results: From 2003 to 2006, 4,840 referrals were made to surgeons (57%) and nonsurgeons (43%). Breast cancers were found in 8.5% of patients. Referral error occurred in 4 cancer patients (.1%). BHP-referred patients had significantly shorter times to surgical appointment (10 days) than non-BHP referrals (45 days). A referring provider survey indicated 96% satisfaction. Conclusions: A breast-care triage system expedited cancer care resulting in. physician satisfaction and increased referrals. (c) 2007 Excerpta Medica Inc. All rights reserved.
机构:
Univ Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, BrazilUniv Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, Brazil
Nogueira, M. C.
Guerra, M. R.
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Univ Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, BrazilUniv Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, Brazil
Guerra, M. R.
Bustamante-Teixeira, M. T.
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Univ Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, BrazilUniv Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, Brazil
Bustamante-Teixeira, M. T.
Silva, G. Azevedo e
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h-index: 0
机构:
Univ Estado Rio De Janeiro, Inst Med Social, Rio De Janeiro, RJ, BrazilUniv Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, Brazil
Silva, G. Azevedo e
Tomazelli, J.
论文数: 0引用数: 0
h-index: 0
机构:
Inst Nacl Canc, Div Pesquisa Populac, Rio De Janeiro, RJ, BrazilUniv Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, Brazil
Tomazelli, J.
Pereira, D. de A.
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h-index: 0
机构:
Univ Fed Vicosa, Vicosa, MG, BrazilUniv Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, Brazil
Pereira, D. de A.
Ribeiro, C. M.
论文数: 0引用数: 0
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机构:
Inst Nacl Canc, Div Deteccao Precoce & Apoioa Org Rede, Rio De Janeiro, RJ, BrazilUniv Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, Brazil
Ribeiro, C. M.
Naghavi, M.
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机构:
Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA USAUniv Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, Brazil
Naghavi, M.
Malta, D. C.
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h-index: 0
机构:
Univ Fed Minas Gerais, Dept Enfermagem Materno Infantil & Saude Publ, Belo Horizonte, MG, BrazilUniv Fed Juiz de Fora, Programa Posgrad Saude Colet, Juiz De Fora, MG, Brazil
机构:
New York State Dept Hlth, Empire State Plaza,Corning Tower Rm 1938, Albany, NY 12237 USANew York State Dept Hlth, Empire State Plaza,Corning Tower Rm 1938, Albany, NY 12237 USA
Proj, Anisa
Wagner, Victoria L.
论文数: 0引用数: 0
h-index: 0
机构:
New York State Dept Hlth, Empire State Plaza,Corning Tower Rm 1938, Albany, NY 12237 USANew York State Dept Hlth, Empire State Plaza,Corning Tower Rm 1938, Albany, NY 12237 USA
Wagner, Victoria L.
Matson, Jacqueline M.
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New York State Dept Hlth, Empire State Plaza,Corning Tower Rm 1938, Albany, NY 12237 USANew York State Dept Hlth, Empire State Plaza,Corning Tower Rm 1938, Albany, NY 12237 USA
Matson, Jacqueline M.
Roohan, Patrick J.
论文数: 0引用数: 0
h-index: 0
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MVP Hlth Care, Schenectady, NY USANew York State Dept Hlth, Empire State Plaza,Corning Tower Rm 1938, Albany, NY 12237 USA
机构:
Univ Washington, Sch Publ Hlth, Dept Epidemiol, Seattle, WA USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Guo, Boya
Wernli, Karen J.
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h-index: 0
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Kaiser Permanente Washington Hlth Res Inst, Seattle, WA USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Wernli, Karen J.
Mittendorf, Kathleen F. F.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Ctr Hlth Res, Dept Translat & Appl Genom TAG, Portland, OR USA
Vanderbilt Univ, Vanderbilt Ingram Canc Ctr, Med Ctr, Nashville, TN USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Mittendorf, Kathleen F. F.
Feigelson, Heather Spencer
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente, Inst Hlth Res, Denver, CO USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Feigelson, Heather Spencer
Gilmore, Marian J. J.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Ctr Hlth Res, Dept Translat & Appl Genom TAG, Portland, OR USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Gilmore, Marian J. J.
Jarvik, Gail P. P.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Washington, Sch Med, Dept Med, Seattle, WA USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Jarvik, Gail P. P.
Kauffman, Tia L. L.
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h-index: 0
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Kaiser Permanente Ctr Hlth Res, Portland, OR USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Kauffman, Tia L. L.
Keast, Erin
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Ctr Hlth Res, Portland, OR USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Keast, Erin
Liles, Elizabeth G. G.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Ctr Hlth Res, Portland, OR USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Liles, Elizabeth G. G.
Lynch, Frances L. L.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Ctr Hlth Res, Portland, OR USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Lynch, Frances L. L.
Muessig, Kristin R. R.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Ctr Hlth Res, Dept Translat & Appl Genom TAG, Portland, OR USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Muessig, Kristin R. R.
Okuyama, Sonia
论文数: 0引用数: 0
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机构:
Denver Hlth & Hosp Author, Denver, CO USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Okuyama, Sonia
Veenstra, David L. L.
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机构:
Univ Washington, Sch Pharm, Dept Pharm, Seattle, WA USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Veenstra, David L. L.
Zepp, Jamilyn M. M.
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h-index: 0
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Kaiser Permanente Ctr Hlth Res, Dept Translat & Appl Genom TAG, Portland, OR USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Zepp, Jamilyn M. M.
Wilfond, Benjamin S. S.
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机构:
Univ Washington, Sch Med, Dept Pediat, Seattle, WA USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Wilfond, Benjamin S. S.
Devine, Beth
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h-index: 0
机构:
Univ Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Univ Washington, Sch Pharm, Dept Pharm, Seattle, WA USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
Devine, Beth
Goddard, Katrina A. B.
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Kaiser Permanente Ctr Hlth Res, Dept Translat & Appl Genom TAG, Portland, OR USA
NCI, Div Canc Control & Populat Sci, Bethesda, MD USAUniv Washington, Sch Publ Hlth, Dept Hlth Syst & Populat Hlth, Box 351621, Seattle, WA 98195 USA
机构:
Emory Univ, Sch Med, Dept Radiol & Imaging Sci, 101 Woodruff Circle,Woodruff Mem Res Bldg, Atlanta, GA 30322 USA
Emory Univ, Rollins Sch Publ Hlth, Dept Hlth Policy & Management, Atlanta, GA 30322 USA
Boston Univ, Sch Publ Hlth, Dept Hlth Law Policy & Management, Boston, MA USAEmory Univ, Sch Med, Dept Radiol & Imaging Sci, 101 Woodruff Circle,Woodruff Mem Res Bldg, Atlanta, GA 30322 USA
Horny, Michal
Shwartz, Michael
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机构:
Boston Univ, Questrom Sch Business, Boston, MA 02215 USA
US Dept Vet Affairs, Ctr Healthcare Org & Implementat Res, Boston, MA USAEmory Univ, Sch Med, Dept Radiol & Imaging Sci, 101 Woodruff Circle,Woodruff Mem Res Bldg, Atlanta, GA 30322 USA
Shwartz, Michael
Duszak, Richard
论文数: 0引用数: 0
h-index: 0
机构:
Emory Univ, Sch Med, Dept Radiol & Imaging Sci, 101 Woodruff Circle,Woodruff Mem Res Bldg, Atlanta, GA 30322 USAEmory Univ, Sch Med, Dept Radiol & Imaging Sci, 101 Woodruff Circle,Woodruff Mem Res Bldg, Atlanta, GA 30322 USA
Duszak, Richard
Christiansen, Cindy L.
论文数: 0引用数: 0
h-index: 0
机构:
Boston Univ, Sch Publ Hlth, Dept Hlth Law Policy & Management, Boston, MA USAEmory Univ, Sch Med, Dept Radiol & Imaging Sci, 101 Woodruff Circle,Woodruff Mem Res Bldg, Atlanta, GA 30322 USA
Christiansen, Cindy L.
Cohen, Alan B.
论文数: 0引用数: 0
h-index: 0
机构:
Boston Univ, Questrom Sch Business, Boston, MA 02215 USAEmory Univ, Sch Med, Dept Radiol & Imaging Sci, 101 Woodruff Circle,Woodruff Mem Res Bldg, Atlanta, GA 30322 USA
Cohen, Alan B.
Burgess, James F., Jr.
论文数: 0引用数: 0
h-index: 0
机构:
Boston Univ, Sch Publ Hlth, Dept Hlth Law Policy & Management, Boston, MA USA
US Dept Vet Affairs, Ctr Healthcare Org & Implementat Res, Boston, MA USAEmory Univ, Sch Med, Dept Radiol & Imaging Sci, 101 Woodruff Circle,Woodruff Mem Res Bldg, Atlanta, GA 30322 USA
机构:
Kaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USAKaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USA
Kroenke, Candyce H.
Hershman, Dawn L.
论文数: 0引用数: 0
h-index: 0
机构:
Columbia Univ, Med Ctr, New York, NY USAKaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USA
Hershman, Dawn L.
Gomez, Scarlett L.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Francisco, San Francisco, CA 94143 USA
Canc Prevent Inst Calif, Fremont, CA USA
Stanford Canc Inst, Stanford, CA USAKaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USA
Gomez, Scarlett L.
Adams, Sara R.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USAKaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USA
Adams, Sara R.
Eldridge, Elizabeth H.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USAKaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USA
Eldridge, Elizabeth H.
Kwan, Marilyn L.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USAKaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USA
Kwan, Marilyn L.
Ergas, Isaac J.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USAKaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USA
Ergas, Isaac J.
Kubo, Ai
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USAKaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USA
Kubo, Ai
Kushi, Lawrence H.
论文数: 0引用数: 0
h-index: 0
机构:
Kaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USAKaiser Permanente Northern Calif, Div Res, 2000 Broadway,5th Floor, Oakland, CA 94611 USA