Use of physician services during the survivorship phase: a multi-province study of women diagnosed with breast cancer
Identifieur interne : 000040 ( Main/Exploration ); précédent : 000039; suivant : 000041Use of physician services during the survivorship phase: a multi-province study of women diagnosed with breast cancer
Auteurs : C. Kendell ; K. M. Decker [Canada] ; P. A. Groome ; M. L. Mcbride ; L. Jiang ; M. K. Krzyzanowska ; G. Porter ; D. Turner [Canada] ; R. Urquhart ; M. Winget [États-Unis] ; E. Grunfeld [Canada]Source :
- Current Oncology [ 1198-0052 ] ; 2017.
Abstract
Oncologists have traditionally been responsible for providing routine follow-up care for cancer survivors; in recent years, however, primary care providers (
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.
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
Optimizing the role of
Url:
DOI: 10.3747/co.24.3454
PubMed: 28490921
PubMed Central: 5407870
Affiliations:
- Canada, États-Unis
- Manitoba, Ontario
- Toronto, Winnipeg
- Université de Toronto, Université du Manitoba
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Le document en format XML
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<wicri:noCountry code="subfield">NS</wicri:noCountry>
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<author><name sortKey="Turner, D" sort="Turner, D" uniqKey="Turner D" first="D." last="Turner">D. Turner</name>
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<wicri:noCountry code="subfield">MB</wicri:noCountry>
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<placeName><settlement type="city">Winnipeg</settlement>
<region type="state">Manitoba</region>
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<author><name sortKey="Urquhart, R" sort="Urquhart, R" uniqKey="Urquhart R" first="R." last="Urquhart">R. Urquhart</name>
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<wicri:noCountry code="subfield">NS</wicri:noCountry>
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<author><name sortKey="Grunfeld, E" sort="Grunfeld, E" uniqKey="Grunfeld E" first="E." last="Grunfeld">E. Grunfeld</name>
<affiliation wicri:level="4"><nlm:aff id="af11-conc-24-81">Department of Family and Community Medicine, University of Toronto, Toronto, ON.</nlm:aff>
<orgName type="university">Université de Toronto</orgName>
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<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
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<series><title level="j">Current Oncology</title>
<idno type="ISSN">1198-0052</idno>
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<front><div type="abstract" xml:lang="en"><sec><title>Introduction</title>
<p>Oncologists have traditionally been responsible for providing routine follow-up care for cancer survivors; in recent years, however, primary care providers (<sc>pcp</sc>
s) 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.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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 <sc>pcp</sc>
-led follow-up care.</p>
</sec>
<sec><title>Conclusions</title>
<p>Optimizing the role of <sc>pcp</sc>
s in breast cancer follow-up care might require strategies to change attitudes about <sc>pcp</sc>
-led follow-up and to better support <sc>pcp</sc>
s in providing survivorship care.</p>
</sec>
</div>
</front>
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<li>États-Unis</li>
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<li>Ontario</li>
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<settlement><li>Toronto</li>
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<tree><noCountry><name sortKey="Groome, P A" sort="Groome, P A" uniqKey="Groome P" first="P. A." last="Groome">P. A. Groome</name>
<name sortKey="Jiang, L" sort="Jiang, L" uniqKey="Jiang L" first="L." last="Jiang">L. Jiang</name>
<name sortKey="Kendell, C" sort="Kendell, C" uniqKey="Kendell C" first="C." last="Kendell">C. Kendell</name>
<name sortKey="Krzyzanowska, M K" sort="Krzyzanowska, M K" uniqKey="Krzyzanowska M" first="M. K." last="Krzyzanowska">M. K. Krzyzanowska</name>
<name sortKey="Mcbride, M L" sort="Mcbride, M L" uniqKey="Mcbride M" first="M. L." last="Mcbride">M. L. Mcbride</name>
<name sortKey="Porter, G" sort="Porter, G" uniqKey="Porter G" first="G." last="Porter">G. Porter</name>
<name sortKey="Urquhart, R" sort="Urquhart, R" uniqKey="Urquhart R" first="R." last="Urquhart">R. Urquhart</name>
</noCountry>
<country name="Canada"><region name="Manitoba"><name sortKey="Decker, K M" sort="Decker, K M" uniqKey="Decker K" first="K. M." last="Decker">K. M. Decker</name>
</region>
<name sortKey="Grunfeld, E" sort="Grunfeld, E" uniqKey="Grunfeld E" first="E." last="Grunfeld">E. Grunfeld</name>
<name sortKey="Turner, D" sort="Turner, D" uniqKey="Turner D" first="D." last="Turner">D. Turner</name>
</country>
<country name="États-Unis"><noRegion><name sortKey="Winget, M" sort="Winget, M" uniqKey="Winget M" first="M." last="Winget">M. Winget</name>
</noRegion>
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