TitleLow-income women with breast abnormalities: system predictors of timely diagnostic resolution.
Publication TypeJournal Article
Year of Publication2007
AuthorsMojica, CM, Bastani, R, W Boscardin, J, Ponce, NA
JournalCancer Control
Volume14
Issue2
Pagination176-82
Date Published04/2007
ISSN1073-2748
KeywordsAdult, Aged, Breast Neoplasms, Diagnostic Errors, Female, Hispanic Americans, Hospitals, County, Humans, Los Angeles, Middle Aged, Pilot Projects, Poverty, Referral and Consultation, Socioeconomic Factors, Time Factors, Treatment Outcome
Abstract
 

BACKGROUND: Incomplete or delayed diagnostic resolution of breast abnormalities suspicious for cancer may contribute to poor breast cancer outcomes. We examine system predictors of timely diagnostic resolution in low-income, mostly Latina women with breast abnormalities at two Los Angeles County public hospitals.

METHODS: We collected medical record data on 1,671 women. The outcome--timely diagnostic resolution--was defined as receipt of definitive diagnosis (malignant or benign) within six months of the index referral. Predictors of the outcome were examined with bivariate and multivariate logistic regression models.

RESULTS: Only 56% of women received timely diagnostic resolution; however, the proportion was higher at Hospital B (67%) compared to Hospital A (51%). The effect of predictors differed by hospital. At Hospital B, the odds of timely diagnostic resolution were lower for women with self-identified abnormalities (P <.033) and higher for women referred to Radiology rather than Surgery for their first appointment (P <.005). At Hospital A, the odds of timely diagnostic resolution were higher for women with self-identified abnormalities (P <.043) and lower for women referred to Radiology rather than Surgery for their first appointment (P <.001).

CONCLUSIONS: Rates and predictors of timely diagnostic resolution differed by hospital. System barriers may be a function of referral processes and patient tracking. Interventions may need to be tailored to a hospital's unique culture.

DOI10.1177/107327480701400211
Alternate JournalCancer Control
PubMed ID17387303
Grant List5F31 CA 90204 / CA / NCI NIH HHS / United States
R01 CA 68474 / CA / NCI NIH HHS / United States