Organizational Factors Affecting the Likelihood of Cancer Screening Among VA Patients

Bibliographic Data

ID9101408
AuthorsAnn F Chou (0000-0003-1053-8616, University of Oklahoma Health Sciences Center, corresponding author), Danielle E Rose (0000-0001-6797-2611, Center for the Study of Healthcare Provider Behavior), Melissa M Farmer (Center for the Study of Healthcare Provider Behavior), Melissa Farmer, Ismelda Canelo (Center for the Study of Healthcare Provider Behavior), Elizabeth M Yano (0000-0002-9385-0025, Center for the Study of Healthcare Provider Behavior)
Year2015
Volume53
Issue12
Pages1040-1049
Publication date2015-12-01
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.0000000000000449
PMID26569643
OpenAlexW2432341350
LanguageEN
Citations received2
References cited24

BACKGROUND: Preventive service delivery, including cancer screenings, continues to pose a challenge to quality improvement efforts. Although many studies have focused on person-level characteristics associated with screening, less is known about organizational influences on cancer screening. OBJECTIVES: This study aims to understand the association between organizational factors and adherence to cancer screenings. METHODS: This study employed a cross-sectional design using organizational-level, patient-level, and area-level data. Dependent variables included breast, cervical, and colorectal cancer screening. Organizational factors describing resource sufficiency were constructed using factor analyses from a survey of 250 Veterans Affairs primary care directors. We conducted random-effects logistic regression analyses, modeling cancer screening as a function of organizational factors, controlling for patient-level and area-level factors. RESULTS: Overall, 87% of the patients received mammograms, 92% received cervical and 78% had colorectal screening. Quality improvement orientation increased the odds of cervical [odds ratio (OR): 1.27; 95% confidence interval (CI), 1.03-1.57] and colorectal cancer screening (OR: 1.10; 95% CI, 1.00-1.20). Authority in determining primary care components increased the odds of mammography screening (OR: 1.23; 95% CI, 1.03-1.51). Sufficiency in clinical staffing increased the odds of mammography and cervical cancer screenings. Several patient-level factors, serving as control variables, were associated with achievement of screenings. CONCLUSIONS: Resource sufficiency led to increased odds of screening possibly because they promote excellence in patient care by conveying organizational goals and facilitate goal achievement with resources. Complementary to patient-level factors, our findings identified organizational processes associated with better performance, which offer concrete strategies in which facilities can evaluate their capabilities to implement best practices to foster and sustain a culture of quality care

Breast cancer · Cancer · Cervical cancer · Colorectal cancer · Confidence interval · Family medicine · Logistic regression · Mammography · Odds · Odds ratio · Staffing · Colorectal Cancer Screening and Detection · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Nursing · Primary Care and Health Outcomes

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