An assessment of the quality of mammography care at facilities treating medically vulnerable populations

L. Elizabeth Goldman, Sebastien J P A Haneuse, Diana L Miglioretti, Karla Kerlikowske, Diana S M Buist, Bonnie Yankaskas, Rebecca Smith-Bindman

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

BACKGROUND: Women in medically vulnerable populations, including racial and ethnic minorities, socioeconomically disadvantaged, and residents of rural areas, experience higher breast cancer mortality than do others. Whether mammography facilities that treat vulnerable women demonstrate lower quality of care than other facilities is unknown. OBJECTIVES: To assess the quality of mammography women receive at facilities characterized as serving a high proportion of medically vulnerable populations. RESEARCH DESIGN: We prospectively collected self-reported breast cancer risk factor information, mammography interpretations, and cancer outcomes on 1,579,929 screening mammography examinations from 750,857 women, aged 40-80 years, attending any of 151 facilities in the Breast Cancer Surveillance Consortium between 1998 and 2004. To classify facilities as serving medically vulnerable populations, we used 4 criteria: educational attainment, racial/ethnic minority, household income, and rural/urban residence. RESULTS: After adjustment for patient-level factors known to affect mammography accuracy, facilities serving vulnerable populations had significantly higher mammography specificity than did other facilities: ie, those serving a higher proportion of women who were minorities [odds ratio (OR): 1.32; 95% confidence interval (CI): 1.01-1.73], living in rural areas (1.45; 1.15-1.73), and with lower household income (1.33; 1.05-1.68). We observed no statistically significant differences between facilities in mammography sensitivity. CONCLUSIONS: Facilities serving high proportions of vulnerable populations provide screening mammography with equal or better quality (as reflected in higher specificity with no corresponding decrease in sensitivity) than other facilities. Further research is needed to understand the mechanisms underlying these findings.

Original languageEnglish (US)
Pages (from-to)701-708
Number of pages8
JournalMedical Care
Volume46
Issue number7
DOIs
StatePublished - Jul 2008
Externally publishedYes

Fingerprint

Quality of Health Care
Vulnerable Populations
Mammography
cancer
Breast Neoplasms
household income
national minority
rural area
Odds Ratio
Confidence Intervals
surveillance
low income
mortality
confidence
Mortality
minority
resident
Research
examination
interpretation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Goldman, L. E., Haneuse, S. J. P. A., Miglioretti, D. L., Kerlikowske, K., Buist, D. S. M., Yankaskas, B., & Smith-Bindman, R. (2008). An assessment of the quality of mammography care at facilities treating medically vulnerable populations. Medical Care, 46(7), 701-708. https://doi.org/10.1097/MLR.0b013e3181789329

An assessment of the quality of mammography care at facilities treating medically vulnerable populations. / Goldman, L. Elizabeth; Haneuse, Sebastien J P A; Miglioretti, Diana L; Kerlikowske, Karla; Buist, Diana S M; Yankaskas, Bonnie; Smith-Bindman, Rebecca.

In: Medical Care, Vol. 46, No. 7, 07.2008, p. 701-708.

Research output: Contribution to journalArticle

Goldman, LE, Haneuse, SJPA, Miglioretti, DL, Kerlikowske, K, Buist, DSM, Yankaskas, B & Smith-Bindman, R 2008, 'An assessment of the quality of mammography care at facilities treating medically vulnerable populations', Medical Care, vol. 46, no. 7, pp. 701-708. https://doi.org/10.1097/MLR.0b013e3181789329
Goldman, L. Elizabeth ; Haneuse, Sebastien J P A ; Miglioretti, Diana L ; Kerlikowske, Karla ; Buist, Diana S M ; Yankaskas, Bonnie ; Smith-Bindman, Rebecca. / An assessment of the quality of mammography care at facilities treating medically vulnerable populations. In: Medical Care. 2008 ; Vol. 46, No. 7. pp. 701-708.
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