Use of physician services during the survivorship phase: a multi-province study of women diagnosed with breast cancer

被引:18
作者
Kendell, C. [2 ,3 ]
Decker, K. M. [4 ,5 ]
Groome, P. A. [1 ]
McBride, M. L. [6 ]
Jiang, L. [1 ]
Krzyzanowska, M. K. [7 ,8 ]
Porter, G. [2 ,3 ,9 ]
Turner, D. [5 ,10 ]
Urquhart, R. [2 ,3 ,9 ]
Winget, M. [11 ]
Grunfeld, E. [12 ]
机构
[1] Queens Univ, Div Canc Care & Epidemiol, Canc Res Inst, Kingston, ON K7L 3N6, Canada
[2] Dalhousie Univ, Canc Outcomes Res Program, Halifax, NS, Canada
[3] Nova Scotia Hlth Author, Halifax, NS, Canada
[4] Univ Manitoba, Dept Community Hlth Sci, Winnipeg, MB, Canada
[5] Canc Care Manitoba, Epidemiol & Canc Registry, Winnipeg, MB, Canada
[6] BC Canc Agcy, Canc Control Res, Vancouver, BC, Canada
[7] Univ Hlth Network, Toronto, ON, Canada
[8] Canc Care Ontario, Toronto, ON, Canada
[9] Dalhousie Univ, Dept Surg, Halifax, NS, Canada
[10] Univ Manitoba, Winnipeg, MB, Canada
[11] Stanford Univ, Sch Med, Stanford, CA 94305 USA
[12] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada
基金
加拿大健康研究院;
关键词
Breast cancer; survivors; follow-up care; primary care; PRIMARY-CARE PHYSICIANS; ROUTINE FOLLOW-UP; RANDOMIZED-TRIAL; SPECIALIST CARE; ONCOLOGISTS; PREFERENCES; GUIDELINES; ATTITUDES; PATIENT; UPDATE;
D O I
10.3747/co.24.3454
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction Oncologists have traditionally been responsible for providing routine follow-up care for cancer survivors; in recent years, however, primary care providers (PCPS) are taking a greater role in care during the follow-up period. In the present study, we used a longitudinal multi-province retrospective cohort study to examine how primary care and specialist care intersect in the delivery of breast cancer follow-up care. Methods Various databases ( registry, clinical, and administrative) were linked in each of four provinces: British Columbia, Manitoba, Ontario, and Nova Scotia. Population-based cohorts of breast cancer survivors were identified in each province. Physician visits were identified using billings or claims data and were classified as visits to primary care ( total, breast cancer-specific, and other), oncology ( medical oncology, radiation oncology, and surgery), and other specialties. The mean numbers of visits by physician type and specialty, or by combinations thereof, were examined. The mean numbers of visits for each follow-up year were also examined by physician type. Results The results showed that many women (>64%) in each province received care from both primary care and oncology providers during the follow-up period. The mean number of breast cancer-specific visits to primary care and visits to oncology declined with each follow-up year. Interprovincial variations were observed, with greater surgeon follow-up in Nova Scotia and greater primary care follow-up in British Columbia. Provincial differences could reflect variations in policies and recommendations, relevant initiatives, and resources or infrastructure to support PCP-led follow-up care. Conclusions Optimizing the role of PCPS in breast cancer follow-up care might require strategies to change attitudes about PCP-led follow-up and to better support pcps in providing survivorship care.
引用
收藏
页码:81 / 89
页数:9
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