ASPO Abstracts
Describing the Healthcare Experiences of Older Breast Cancer Survivors: Identifying Person-Level Factors Associated with Positive Care Experiences
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2019
Abstract Body:
PURPOSE: Positive healthcare experiences are associated with important outcomes among older cancer survivors, including adherence to follow-up care guidelines. We sought to describe person-level factors associated with positive care experiences among older breast cancer survivors.METHODS: We used the Surveillance, Epidemiology, and End Results (SEER) and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) population-based, linked data resource to examine three dimensions of perceived healthcare experience: CAHPS composites Getting Needed Care, Getting Care Quickly, and Doctor Communication. Associations between sociodemographic factors, cancer history (e.g. time since diagnosis), and health history (e.g. number of comorbid conditions), and CAHPS subscales were examined. Women (N=332) with Stage I-IV breast cancer diagnosed at 65 years or older were included, and generalized linear models were analyzed for each CAHPS composite, adjusting for CAHPS case-mix adjustment variables (e.g. self-reported mental and general health).RESULTS: Compared with survivors who had at least one comorbid condition, survivors without comorbid conditions were significantly more likely to report receiving care quickly (β=10.18 p < .001). Survivors were also more likely to report receiving care quickly as the number of months since diagnosis increased (β=0.20, p = .021). Survivors were less likely to report receiving needed care as their reported general health status increased (β=-3.57, p = .009). Finally, survivors with some college education or more (compared to high school education or less, β=-6.30, p = .001) and reported higher general health status (β=-2.51, p = .019) were more likely to report poorer communication with their doctor.CONCLUSIONS: Breast cancer survivors make up the highest proportion of older female cancer survivors. Understanding how to improve their care experiences is central to improving health outcomes among this population. Our results suggest that the characteristics of survivors experiencing poorer care differ within the three domains we examined, suggesting that a tailored approach to improving care delivery is necessary. Some of the potential targets for intervention identified include patients with higher comorbidity burden.
Keywords: Survivorship, Breast Cancer, Older Adults, Healthcare Delivery