Title

Delayed radiotherapy for breast cancer patients in integrated delivery systems

UMMS Affiliation

Meyers Primary Care Institute

Date

11-10-2009

Document Type

Article

Medical Subject Headings

Aged; Breast Neoplasms; Continental Population Groups; *Delivery of Health Care, Integrated; Female; Humans; Multivariate Analysis; Time Factors; United States

Disciplines

Health Services Research | Primary Care

Abstract

OBJECTIVE: To identify factors associated with delayed radiotherapy (RT) in older women with early-stage breast cancer.

METHODS: We studied 541 women age >or=65 years diagnosed with early-stage breast cancer in 1990-1994 at 5 integrated healthcare delivery systems and treated with breast-conserving surgery and RT, but not chemotherapy. We examined whether demographic, tumor, or treatment characteristics were associated with RT delays of >8 weeks postsurgery using chi(2) tests and multivariable logistic regression.

RESULTS: Seventy-six women (14%) had delayed RT, with a median delay of 14 weeks. Even though they had insurance and access to care, nonwhite and Hispanic women were much more likely than white women to have delayed RT (odds ratio = 3.3; 95% confidence interval = 1.7, 10) in multivariable analyses that controlled for demographic and clinical variables.

CONCLUSIONS: Timely RT should be facilitated through physician and patient education, navigation, and notification programs to improve quality of care. Queues for RT appointments should be evaluated on an ongoing basis to ensure adequate access. Future research should examine modifiable barriers to RT timeliness and whether delays impact long-term outcomes.

Rights and Permissions

Citation: Am J Manag Care. 2009 Nov;15(11):785-9.

Related Resources

Link to Article in PubMed