Factors affecting follow-up among low-income women with breast abnormalities

Celia Patricia Kaplan, Lori A. Crane, Susan L Stewart, Maria Juarez-Reyes

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: To assess factors affecting follow-up care among low-income women after identification of a breast abnormality. Methods: Women with a newly discovered breast abnormality were selected from one public hospital and two comprehensive health centers (CHCs) in Los Angeles county. Twelve months later, a telephone survey and medical chart review were conducted. Results: Of the 535 respondents, 8.6% received no follow-up care. Among those with follow-up care, 29.4% received inadequate care (did not initiate follow-up in a timely manner or did not complete all recommended procedures). Factors affecting receipt of any follow-up care included having the index visit at a CHC vs. a hospital (OR 2.79, CI 1.20-6.50), patient uncertainty about where to receive care (OR 0.24, CI 0.07-0.77), and recommendation of a clinical breast examination (CBE) (OR 0.12, CI 0.04-0.40) or 6-month mammogram (OR 0.11, CI 0.04-0.31) vs. a diagnostic mammogram as a first follow-up procedure. Factors affecting receipt of adequate follow-up care included index visit at a CHC vs. a hospital (OR 1.90, CI 1.13-3.20), being white/Asian Pacific Islander/other vs. Latina (OR 5.33, CI 1.71-16.68), recommendation of a 6-month mammogram vs. a diagnostic mammogram (OR 0.06, CI 0.02-0.14), and a family history of breast cancer (OR 0.44, CI 0.22-0.89). Conclusions: To maximize return for follow-up among low-income women with a breast abnormality, clear information should be provided about where to obtain care, particularly to patients in hospital settings. The importance of complete and timely follow-up care should be emphasized, especially with referrals for clinical breast examinations or 6-month mammograms.

Original languageEnglish (US)
Pages (from-to)195-205
Number of pages11
JournalJournal of Women's Health
Volume13
Issue number2
DOIs
StatePublished - Mar 2004
Externally publishedYes

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Aftercare
Breast
Health
Los Angeles
Public Hospitals
Hispanic Americans
Telephone
Uncertainty
Referral and Consultation
Breast Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Factors affecting follow-up among low-income women with breast abnormalities. / Kaplan, Celia Patricia; Crane, Lori A.; Stewart, Susan L; Juarez-Reyes, Maria.

In: Journal of Women's Health, Vol. 13, No. 2, 03.2004, p. 195-205.

Research output: Contribution to journalArticle

Kaplan, Celia Patricia ; Crane, Lori A. ; Stewart, Susan L ; Juarez-Reyes, Maria. / Factors affecting follow-up among low-income women with breast abnormalities. In: Journal of Women's Health. 2004 ; Vol. 13, No. 2. pp. 195-205.
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abstract = "Purpose: To assess factors affecting follow-up care among low-income women after identification of a breast abnormality. Methods: Women with a newly discovered breast abnormality were selected from one public hospital and two comprehensive health centers (CHCs) in Los Angeles county. Twelve months later, a telephone survey and medical chart review were conducted. Results: Of the 535 respondents, 8.6{\%} received no follow-up care. Among those with follow-up care, 29.4{\%} received inadequate care (did not initiate follow-up in a timely manner or did not complete all recommended procedures). Factors affecting receipt of any follow-up care included having the index visit at a CHC vs. a hospital (OR 2.79, CI 1.20-6.50), patient uncertainty about where to receive care (OR 0.24, CI 0.07-0.77), and recommendation of a clinical breast examination (CBE) (OR 0.12, CI 0.04-0.40) or 6-month mammogram (OR 0.11, CI 0.04-0.31) vs. a diagnostic mammogram as a first follow-up procedure. Factors affecting receipt of adequate follow-up care included index visit at a CHC vs. a hospital (OR 1.90, CI 1.13-3.20), being white/Asian Pacific Islander/other vs. Latina (OR 5.33, CI 1.71-16.68), recommendation of a 6-month mammogram vs. a diagnostic mammogram (OR 0.06, CI 0.02-0.14), and a family history of breast cancer (OR 0.44, CI 0.22-0.89). Conclusions: To maximize return for follow-up among low-income women with a breast abnormality, clear information should be provided about where to obtain care, particularly to patients in hospital settings. The importance of complete and timely follow-up care should be emphasized, especially with referrals for clinical breast examinations or 6-month mammograms.",
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