Changes in primary care provider utilization by phase of care for women diagnosed with breast cancer: a CanIMPACT longitudinal cohort study
Abstract Background Primary care providers (PCPs) have always played an important role in cancer diagnosis. There is increasing awareness of the importance of their role during treatment and survivorship. We examined changes in PCP utilization from pre-diagnosis to survival for women diagnosed with...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | BMC Family Practice |
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| Online Access: | http://link.springer.com/article/10.1186/s12875-019-1052-2 |
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| author | K. Decker R. Moineddin C. Kendell R. Urquhart N. Biswanger P. Groome M. L. McBride M. Winget M. Whitehead E. Grunfeld for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (CanIMPACT) |
| author_facet | K. Decker R. Moineddin C. Kendell R. Urquhart N. Biswanger P. Groome M. L. McBride M. Winget M. Whitehead E. Grunfeld for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (CanIMPACT) |
| author_sort | K. Decker |
| collection | DOAJ |
| description | Abstract Background Primary care providers (PCPs) have always played an important role in cancer diagnosis. There is increasing awareness of the importance of their role during treatment and survivorship. We examined changes in PCP utilization from pre-diagnosis to survival for women diagnosed with breast cancer, factors associated with being a high user of primary care, and variation across four Canadian provinces. Methods The cohorts included women 18+ years of age diagnosed with stage I-III invasive breast cancer in years 2007–2012 in British Columbia (BC), Manitoba (MB), Ontario (ON), and Nova Scotia (NS) who had surgery plus adjuvant chemotherapy and were alive 30+ months after diagnosis (N = 19,589). We compared the rate of PCP visits in each province across phases of care (pre-diagnosis, diagnosis, treatment, and survival years 1 to 4). Results PCP use was greatest during treatment and decreased with each successive survival year in all provinces. The unadjusted difference in PCP use between treatment and pre-diagnosis was most pronounced in BC where PCP use was six times higher during treatment than pre-diagnosis. Factors associated with being a high user of primary care during treatment included comorbidity and being a high user of care pre-diagnosis in all provinces. These factors were also associated with being a higher user of care during diagnosis and survival. Conclusions Contrary to the traditional view that PCPs focus primarily on cancer prevention and early detection, we found that PCPs are involved in the care of women diagnosed with breast cancer across all phases of care. |
| first_indexed | 2024-12-12T15:10:20Z |
| format | Article |
| id | doaj.art-76090c548c0d4e81b79f330fb7a0fe26 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-12-12T15:10:20Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-76090c548c0d4e81b79f330fb7a0fe262022-12-22T00:20:38ZengBMCBMC Family Practice1471-22962019-11-012011810.1186/s12875-019-1052-2Changes in primary care provider utilization by phase of care for women diagnosed with breast cancer: a CanIMPACT longitudinal cohort studyK. Decker0R. Moineddin1C. Kendell2R. Urquhart3N. Biswanger4P. Groome5M. L. McBride6M. Winget7M. Whitehead8E. Grunfeld9for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (CanIMPACT)CancerCare ManitobaUniversity of Toronto, 500 University AvenueDalhousie UniversityDalhousie UniversityCancerCare ManitobaQueen’s UniversityBC Cancer AgencyStanford UniversityQueen’s UniversityUniversity of Toronto, 500 University AvenueAbstract Background Primary care providers (PCPs) have always played an important role in cancer diagnosis. There is increasing awareness of the importance of their role during treatment and survivorship. We examined changes in PCP utilization from pre-diagnosis to survival for women diagnosed with breast cancer, factors associated with being a high user of primary care, and variation across four Canadian provinces. Methods The cohorts included women 18+ years of age diagnosed with stage I-III invasive breast cancer in years 2007–2012 in British Columbia (BC), Manitoba (MB), Ontario (ON), and Nova Scotia (NS) who had surgery plus adjuvant chemotherapy and were alive 30+ months after diagnosis (N = 19,589). We compared the rate of PCP visits in each province across phases of care (pre-diagnosis, diagnosis, treatment, and survival years 1 to 4). Results PCP use was greatest during treatment and decreased with each successive survival year in all provinces. The unadjusted difference in PCP use between treatment and pre-diagnosis was most pronounced in BC where PCP use was six times higher during treatment than pre-diagnosis. Factors associated with being a high user of primary care during treatment included comorbidity and being a high user of care pre-diagnosis in all provinces. These factors were also associated with being a higher user of care during diagnosis and survival. Conclusions Contrary to the traditional view that PCPs focus primarily on cancer prevention and early detection, we found that PCPs are involved in the care of women diagnosed with breast cancer across all phases of care.http://link.springer.com/article/10.1186/s12875-019-1052-2Primary health careBreast neoplasmsClinical decision-making |
| spellingShingle | K. Decker R. Moineddin C. Kendell R. Urquhart N. Biswanger P. Groome M. L. McBride M. Winget M. Whitehead E. Grunfeld for the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (CanIMPACT) Changes in primary care provider utilization by phase of care for women diagnosed with breast cancer: a CanIMPACT longitudinal cohort study BMC Family Practice Primary health care Breast neoplasms Clinical decision-making |
| title | Changes in primary care provider utilization by phase of care for women diagnosed with breast cancer: a CanIMPACT longitudinal cohort study |
| title_full | Changes in primary care provider utilization by phase of care for women diagnosed with breast cancer: a CanIMPACT longitudinal cohort study |
| title_fullStr | Changes in primary care provider utilization by phase of care for women diagnosed with breast cancer: a CanIMPACT longitudinal cohort study |
| title_full_unstemmed | Changes in primary care provider utilization by phase of care for women diagnosed with breast cancer: a CanIMPACT longitudinal cohort study |
| title_short | Changes in primary care provider utilization by phase of care for women diagnosed with breast cancer: a CanIMPACT longitudinal cohort study |
| title_sort | changes in primary care provider utilization by phase of care for women diagnosed with breast cancer a canimpact longitudinal cohort study |
| topic | Primary health care Breast neoplasms Clinical decision-making |
| url | http://link.springer.com/article/10.1186/s12875-019-1052-2 |
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