Perceptions of care coordination in a population-based sample of diverse breast cancer patients

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% Cl: 2.78-5.41; OR = 3.19 95% Cl: 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. Practice implications: Providers should be aware of the health literacy deficits that may contribute to their patients' attitudes towards their breast cancer care coordination. Published by Elsevier Ireland Ltd.