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Titolo:
Discussion of treatment options for early-stage breast cancer: Effect of provider specialty on type of surgery and satisfaction
Autore:
Keating, NL; Weeks, JC; Landrum, MB; Borbas, C; Guadagnoli, E;
Indirizzi:
Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA HarvardUniv Boston MA USA 02115 t Hlth Care Policy, Boston, MA 02115 USA Brigham & Womens Hosp, Dept Med, Div Gen Internal Med, Sect Hlth Serv & Policy Res, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 olicy Res, Boston, MA 02115 USA Dana Farber Canc Inst, Dept Adult Oncol, Boston, MA 02115 USA Dana Farber Canc Inst Boston MA USA 02115 ult Oncol, Boston, MA 02115 USA Healthcare Educ & Res Fdn Inc, St Paul, MN USA Healthcare Educ & Res Fdn Inc St Paul MN USA es Fdn Inc, St Paul, MN USA
Titolo Testata:
MEDICAL CARE
fascicolo: 7, volume: 39, anno: 2001,
pagine: 681 - 691
SICI:
0025-7079(200107)39:7<681:DOTOFE>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
COMPARING TOTAL MASTECTOMY; CONSERVING SURGERY; GEOGRAPHIC-VARIATION; OLDER WOMEN; CARE; DETERMINANTS; GUIDELINES; MANAGEMENT; CARCINOMA; PATTERNS;
Keywords:
breast neoplasms; mastectomy; breast-conserving surgery; patient satisfaction; referral and consultation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Keating, NL Harvard Univ, Sch Med, Dept Hlth Care Policy, 180 Longwood Ave, Boston, MA02115 USA Harvard Univ 180 Longwood Ave Boston MA USA 02115 MA02115 USA
Citazione:
N.L. Keating et al., "Discussion of treatment options for early-stage breast cancer: Effect of provider specialty on type of surgery and satisfaction", MED CARE, 39(7), 2001, pp. 681-691

Abstract

OBJECTIVES. To describe the physicians with whom breast cancer patients discuss treatment options and assess whether discussing surgical options witha medical oncologist is associated with type of surgery and satisfaction. RESEARCH DESIGN. Medical record abstraction and survey. SUBJECTS. Women With early-stage breast cancer numbering 2,426 in two states - Massachusetts, where the rate of breast-conserving surgery is high, and Minnesota, where it is lower. MEASURES. Receipt of breast-conserving surgery and satisfaction. RESULTS. Women in Massachusetts discussed breast cancer treatments with more physicians than women in Minnesota (mean 3.5 vs. 2.8; P <0.001) and moreoften discussed surgical options with a medical oncologist (52% vs. 28%; P<0.001). Using propensity score analyses, in Massachusetts, discussing surgical options with a medical oncologist was not related to type of surgery (adjusted difference in rate of breast-conserving surgery: 3.9%, 95% CI -3.6% to 11.5%) but was associated with greater satisfaction (adjusted difference: 8.1, 95% CI 2.0% to 14.2%). In Minnesota, discussing surgical options with a medical oncologist was associated with breast-conserving surgery (adjusted difference: 12.6%, 95% CI 5.6% to 19.7%) with no difference in satisfaction (adjusted difference: -1.5%, 95% CI -6.8% to 3.8%). CONCLUSIONS. Outcomes associated with discussing surgical treatments with a medical oncologist vary with local care patterns. Where breast-conservingsurgery is standard care, seeing a medical oncologist is not related to type of surgery, but is associated with greater satisfaction. Where it is notthe standard, seeing a medical oncologist is associated with more breast-conserving surgery and equivalent satisfaction. These findings suggest that collaborative care may benefit women with respect to treatment selection orsatisfaction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 00:00:41