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

Patient Educ Couns. 2010 Dec:81 Suppl:S34-40. doi: 10.1016/j.pec.2010.08.009. Epub 2010 Nov 12.


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.

Keywords: breast cancer; coordination of care; health literacy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / ethnology*
  • Breast Neoplasms / therapy*
  • Continuity of Patient Care
  • Delivery of Health Care / organization & administration*
  • Ethnicity / statistics & numerical data*
  • Female
  • Health Literacy*
  • Humans
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Patient Satisfaction
  • Quality of Health Care*
  • SEER Program
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult