Organizational Factors Affect Safety-Net Hospitals' Breast Cancer Treatment Rates.

ABSTRACT:

Objective

To identify key organizational approaches associated with underuse of breast cancer care.

Setting

Nine New York City area safety-net hospitals.

Study design

Mixed qualitative-quantitative, cross-sectional cohort.

Methods

We used qualitative comparative analysis (QCA) of key stakeholder interviews, defined organizational "conditions," calibrated conditions, and identified solution pathways. We defined underuse as no radiation after lumpectomy in women <75 years or mastectomy in women with ≥4 positive nodes, or no systemic therapy in women with tumors ≥1 cm. We used hierarchical models to assess organizational and patient factors' impact on underuse.

Principal findings

Underuse varied by hospital (8-29 percent). QCA found lower underuse sites des

SUBMITTER: Bickell NA 

PROVIDER: S-EPMC5682131 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature