ArticleHealth services research2017
Organizational Factors Affect Safety-Net Hospitals' Breast Cancer Treatment Rates.
Article in Health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies.BMJ quality & safety · 2019Pooled it
- Factors Associated with Receipt of Allogeneic Hematopoietic Cell Transplant and NMDP Donor Search in Older Adults with Acute Myeloid Leukemia.Transplantation and cellular therapy · 2026Article
- Patient-Centered Leadership and Co-Design of Services for Breast Cancer Program in Nicaragua.International journal of environmental research and public health · 2025Observational
- Health-care organization characteristics in cancer care delivery: an integrated conceptual framework with content validation.Journal of the National Cancer Institute · 2024Article
- Diversity of interpretations of the concept "patient-centered care for breast cancer patients"; a scoping review of current literature.Journal of evaluation in clinical practice · 2022Article
- Disparate access to breast cancer screening and treatment.BMC women's health · 2022Article
- Identifying actionable strategies: using Consolidated Framework for Implementation Research (CFIR)-informed interviews to evaluate the implementation of a multilevel intervention to improve colorectal cancer screening.Implementation science communications · 2021Article
- Barriers and facilitators to implementing priority inpatient initiatives in the safety net setting.Implementation science communications · 2020Article
- Caution Ahead: Research Challenges of a Randomized Controlled Trial Implemented to Improve Breast Cancer Treatment at Safety-Net Hospitals.Journal of oncology practice · 2018Article
- Implementation science for ambulatory care safety: a novel method to develop context-sensitive interventions to reduce quality gaps in monitoring high-risk patients.Implementation science : IS · 2017Article
Corrections and comments
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Authors and funding
13 authors at 10 institutions in 1 country.
Funding
Abstract
objectiveTo identify key organizational approaches associated with underuse of breast cancer care.
settingNine New York City area safety-net hospitals. STUDY
designMixed qualitative-quantitative, cross-sectional cohort.
methodsWe 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
findingsUnderuse varied by hospital (8-29 percent). QCA found lower underuse sites designated individuals to track and follow-up no-shows; shared clinical information during handoffs; had fully integrated electronic medical records enabling transfer of responsibility across specialties; had strong system support; allocated resources to cancer clinics; had a patient-centered culture paying close organizational attention to clinic patients. High underuse sites lacked these characteristics. Multivariate modeling found that hospitals with strong approaches to follow-up had low underuse rates (RR = 0.28; 0.08-0.95); individual patient characteristics were not significant.
conclusionsAt safety-net hospitals, underuse of needed cancer therapies is associated with organizational approaches to track and follow-up treatment. Findings provide varying approaches to safety nets to improve cancer care delivery.
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Registered trials
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