Perceptions of cancer care may not match reality

In a new study, the impressions of breast cancer patients about the quality of care they received often differed from medical definitions of quality - in part because the patients were judging their experiences by a different set of standards.

Patient perceptions are increasingly important to hospitals and other healthcare providers that find their payments from insurers and the government tied to performance and patient evaluations.

To see what influences a woman’s perception of her care, and how that compares to its actual quality, researchers in New York interviewed 374 women treated for early-stage breast cancer.

They found that most of the women tended to underestimate the quality of care they received. And often, their views were most shaped by the experience of getting care and by how much they trusted their doctors.

“There are a lot of obstacles that you have to get past in order to get what you need, and as a system we need to make it easier to get care,” said the report’s lead author, Dr. Nina Bickell, an associate professor at the Mount Sinai School of Medicine in New York.

Bickell’s group examined data from women who had surgery for their breast cancer at one of eight New York City hospitals between October 2006 and September 2009.

Breast Cancer Statistics
Aside from non-melanoma skin cancer, breast cancer is the most common cancer among women in the United States. It is also one of the leading causes of cancer death among women of all races and Hispanic origin populations. For more information, visit Cancer Among Women.

In 2007 (the most recent year numbers are available)

- 202,964 women in the United States were diagnosed with breast cancer.
- 40,598 women in the United States died from breast cancer.

*Incidence counts cover approximately 99% of the U.S. population. Death counts cover 100% of the U.S. population. Use caution in comparing incidence and death counts.

Source: U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2007 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2010.

The women were surveyed over the phone when they first entered the study, and again six months later. The researchers then looked at the women’s medical records to see what care they actually got.

Just over half - 55 percent - said the care they received was “excellent,” whereas 88 percent actually got good-quality care in line with medical guidelines.

“The thing that’s always been fascinating is the disconnect of what we count as quality, and what we see and feel as quality,” Bickell told Reuters Health.

Breast cancer is a major cause of illness for Australian women
Breast cancer is the most common cancer in women (excluding 2 types of non-reportable skin cancer), representing over a quarter (28%) of all reported cancer cases in women in 2006. A total of 12,614 invasive breast cancer cases were diagnosed in women that year, the largest number recorded to date. More than two-thirds (69%) of these cases were in women aged 40 to 69 years. In the same year, 102 cases of invasive breast cancer were diagnosed in men, accounting for 0.8% of breast cancer cases.

While breast cancer is the most commonly reported cancer in Indigenous women in the four jurisdictions for which data were available, Indigenous women were significantly less likely to be diagnosed with breast cancer than non-Indigenous women in 2002 to 2006 (69 and 103 new cases per 100,000 women, respectively).

Breast cancer was the sixth leading cause of burden of disease for women in 2003 and it accounted for 7% of all years of life lost due to premature mortality.

There were 1,558 cases of ductal carcinoma in situ (a non-invasive tumour of the breast) diagnosed in women in 2005.

The researchers found several aspects of the treatment process shaped how the women viewed their care.

Of the 205 women who called their care “excellent,” more than half (124) also considered their process of obtaining care to be “excellent.” In comparison, only 28 of 169 women who said they received less-than-excellent care thought the process of getting care was “excellent.”

Women who said they received “excellent” care were also more likely to report excellent treatment by medical staff, to say they knew which doctor to go to with questions or concerns and to say they had good trust and communication with their doctor. They were less likely to mistrust the medical system.

Page 1 of 31 2 3 Next »

Provided by ArmMed Media