Perceptions of care coordination in a population-based sample of diverse breast cancer patients.

OBJECTIVE

To identify factors associated with perceptions of care coordination in a diverse sample of breast cancer patients.

METHODS

Breast cancer patients reported to the metropolitan SEER registries of Detroit or Los Angeles from 6/05 to 2/07 were surveyed after diagnosis (N=2268, RR=72.4%). Outcomes were two dichotomous measures reflecting patient appraisal of care coordination during their treatment experience. Primary independent variables were race/ethnicity (white, African American, Latina-high acculturated, Latina-low acculturated) and health literacy (low, moderate, high). Logistic regression was used to evaluate factors associated with both measures of care coordination.

RESULTS

2148 subjects were included in the analytic dataset. 16.4% of women perceived low care coordination and 12.5% reported low satisfaction. Race/ethnicity was not significantly associated with care coordination. Women with low subjective health literacy were 3-4 times as likely as those with high health literacy to perceive low care coordination and low satisfaction with care coordination (OR=3.88; 95% CI: 2.78-5.41; OR=3.19 95% CI: 2.25-4.52, respectively).

CONCLUSIONS

Many breast cancer patients positively appraised their care coordination, but patients with low health literacy perceived low care coordination.

PRACTICE IMPLICATIONS

Providers should be aware of the health literacy deficits that may contribute to their patients' attitudes towards their breast cancer care coordination.