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.