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Is Medical Home Enrollment Associated With Receipt of Guideline-Concordant Follow-up Care Among Low-Income Breast Cancer Survivors

Bibliographic Data

ID9102381
AuthorsStephanie B Wheeler (0000-0002-3399-9047, Cecil College, corresponding author), Racquel E Kohler (0000-0002-1017-3832, corresponding author), Ravi K Goyal, RK Goyal (0000-0003-1632-036X, UNC Lineberger Comprehensive Cancer Center), Kristen Hassmiller Lich (0000-0002-3311-4202, corresponding author), Ching-Ching Lin, Ching-Ching Claire Lin (0000-0002-4882-2826, corresponding author), Alexis Moore (0000-0002-1740-6627, UNC Lineberger Comprehensive Cancer Center), Timothy W Smith (0000-0002-4017-3243, University of North Carolina at Chapel Hill), Cathy L Melvin (0000-0001-7862-5631, Medical University of South Carolina), Katherine Reeder-Hayes, Katherine E Reeder‐Hayes (0000-0001-6903-0177, Cecil College), Marisa Elena Domino (0000-0003-4845-6261, Cecil College, corresponding author)
Year2013
Volume51
Issue6
Pages494-502
Publication date2013-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31828d4d0c
PMID23673393
OpenAlexW2053001954
LanguageEN
Citations received1
References cited28

BACKGROUND: Community Care of North Carolina (CCNC) initiated an innovative medical home program in the 1990 s to improve primary care in Medicaid-insured populations. CCNC has been successful in improving asthma, diabetes, and cardiovascular outcomes but has not been evaluated in the context of cancer care. We explored whether CCNC enrollment was associated with guideline-concordant follow-up care among breast cancer survivors. METHODS: Using state cancer registry records matched to Medicaid claims, we identified women 18 to 64 years old who were diagnosed with stage 0, I, II, or unstaged breast cancer from 2003 to 2007 and tracked their monthly CCNC enrollment. Using published American Society for Clinical Oncology guidelines to define our outcomes, we employed multivariate logistic regressions to examine, as a function of CCNC enrollment, receipt of mammogram and at least 2 physical examinations/history-taking visits within observational windows consistent with the guidelines. RESULTS: Of the 840 women, approximately half were enrolled into the CCNC for some time during the study period. Between 40% and 85% received follow-up mammogram in accordance with guidelines, with significant variation by CCNC status, and 95% of women received at least 2 physical examinations/history-taking visits. In multivariate models, increasing months of CCNC enrollment was significantly positively associated with receipt of follow-up mammogram but not with physical examinations/history-taking visits. CONCLUSIONS: Results suggest that CCNC enrollment is associated with guideline-concordant follow-up care for Medicaid-insured survivors. Given the growing population of cancer survivors and increased emphasis on primary care medical homes, future studies should explore what factors are associated with medical home participation and whether similar findings are observed with extended follow-up

Breast cancer · Cancer · Context (archaeology) · Environmental health · Family medicine · Guideline · Health care · Medicaid · Medical record · MEDLINE · Population · Receipt · Cancer survivorship and care · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Primary Care and Health Outcomes

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Unique citing works1
Citations per year0,09
Citation span2015 - 2015 (1)
Citation velocityhistorical
Highly citedNo
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