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

Hawley ST, Janz NK, Lillie SE, Friese CR, Griggs JJ, Graff JJ, Hamilton AS, Jain S, Katz SJ. Perceptions of care coordination in a population-based sample of diverse breast cancer patients. Patient education and counseling. 2010 Dec 1; 81 Suppl:S34-40.

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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.

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