1. Follow-up care delivery among colorectal cancer survivors most often seen by primary and subspecialty care physicians.
- Author
-
Haggstrom, David A., Arora, Neeraj K., Helft, Paul, Clayman, Marla L., and Oakley-Girvan, Ingrid
- Subjects
- *
HEALTH outcome assessment , *COLON cancer patients , *PATIENT-centered care , *HEALTH surveys , *COLON tumors , *COMPARATIVE studies , *CONTINUUM of care , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL care , *MEDICAL cooperation , *MEDICINE , *PHYSICIANS , *GENERAL practitioners , *PUBLIC health surveillance , *RESEARCH , *RESEARCH funding , *EVALUATION research , *ECONOMICS , *TUMOR treatment ,RECTUM tumors - Abstract
Background: The Institute of Medicine has identified patients as a key source of information for assessing the quality of care.Objective: To evaluate the association of physician specialty with the content and quality of follow-up cancer care.Design and Participants: Three hundred three colorectal cancer (CRC) survivors in Northern California were surveyed 2-5 years post-diagnosis.Measurements: Specialty of physician seen most often [primary care physician (PCP), oncologist, surgeon, or gastroenterologist]; other physician specialties seen; patient characteristics; content of visits; patient-centered quality of follow-up care (communication, coordination, nursing, and staff interactions).Main Results: A minority (16%) of CRC survivors reported that the doctor they most often saw for follow-up cancer care was a PCP, while 60% saw an oncologist. Many CRC survivors (40%) saw >1 physician for follow-up cancer care. Survivors most often seen by PCPs were more likely to have three or more medical comorbidities (70% vs. 51%, p = 0.012) than survivors seen by subspecialty physicians. Survivors seen by PCPs were less likely to report seeing a doctor for medical tests and more likely to report discussing disease prevention (82% vs. 64%, p = 0.012) or diet (70% vs. 48%, p = 0.005) with their doctor. There were no significant specialty differences in patient-centered quality of follow-up cancer care.Conclusions: Cancer survivors' assessment of the quality of care was similar across specialties, while the content of follow-up cancer care varied by physician specialty. These findings provide important information about the potential value of primary care and the need for coordination when delivering care to CRC survivors. [ABSTRACT FROM AUTHOR]- Published
- 2009
- Full Text
- View/download PDF