Factors affecting follow-up among low-income women with breast abnormalities.

Abstract

PURPOSE:

To assess factors affecting follow-up care among low-income women after identification of a breast abnormality.

METHODS:

Women with a newly discovered breast abnormality were selected from one public hospital and two comprehensive health centers (CHCs) in Los Angeles county. Twelve months later, a telephone survey and medical chart review were conducted.

RESULTS:

Of the 535 respondents, 8.6% received no follow-up care. Among those with follow-up care, 29.4% received inadequate care (did not initiate follow-up in a timely manner or did not complete all recommended procedures). Factors affecting receipt of any follow-up care included having the index visit at a CHC vs. a hospital (OR 2.79, CI 1.20-6.50), patient uncertainty about where to receive care (OR 0.24, CI 0.07-0.77), and recommendation of a clinical breast examination (CBE) (OR 0.12, CI 0.04-0.40) or 6-month mammogram (OR 0.11, CI 0.04-0.31) vs. a diagnostic mammogram as a first follow-up procedure. Factors affecting receipt of adequate follow-up care included index visit at a CHC vs. a hospital (OR 1.90, CI 1.13-3.20), being white/Asian Pacific Islander/other vs. Latina (OR 5.33, CI 1.71-16.68), recommendation of a 6-month mammogram vs. a diagnostic mammogram (OR 0.06, CI 0.02-0.14), and a family history of breast cancer (OR 0.44, CI 0.22-0.89).

CONCLUSIONS:

To maximize return for follow-up among low-income women with a breast abnormality, clear information should be provided about where to obtain care, particularly to patients in hospital settings. The importance of complete and timely follow-up care should be emphasized, especially with referrals for clinical breast examinations or 6-month mammograms.

• Authors: Celia Patricia Kaplan, Lori A Crane, Susan Stewart, Maria Juarez-Reyes
• Journal: Journal of women's health (2002) (J Womens Health (Larchmt)) Vol. 13 Issue 2 Pg. 195-206 (Mar 2004) ISSN: 1540-9996 [Print] United States
• PMID: 15072734 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Breast Neoplasms (diagnosis, epidemiology, psychology)
• California (epidemiology)
• Confidence Intervals
• Female
• Follow-Up Studies
• Humans
• Mammography (methods)
• Middle Aged
• Odds Ratio
• Office Visits (statistics & numerical data)
• Patient Education as Topic (statistics & numerical data)
• Poverty (statistics & numerical data)
• Risk Factors
• Time Factors
• Women's Health