ArticleCancer2020
Differences in ambulatory care fragmentation between cancer survivors and noncancer controls.
Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of Continuity of Care Interventions Linking Hospital Care to Primary Healthcare for Patients With Cancer: A Systematic Review and Meta-Analysis.Cancer medicine · 2026Pooled it
- Categorizing continuity of care measures and why you have (probably) been doing it wrong: a methodological discussion and recommendations for researchers.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Diet and Prevention of Cardiovascular Disease and Cancer: JACC: CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2025Review
- Health Care Contact Days Among Older Cancer Survivors.JCO oncology practice · 2024Article
- Availability of cancer survivorship support services across the National Cancer Institute Community Oncology Research Program network.JNCI cancer spectrum · 2024Article
- Impact of care fragmentation on the outcomes of patients receiving neoadjuvant and adjuvant therapy for pancreatic adenocarcinoma.Journal of surgical oncology · 2022Article
- Continuity of care and receipt of aggressive end of life care among women dying of ovarian cancer.Gynecologic oncology · 2021Article
- Healthcare fragmentation and cardiovascular risk control among older cancer survivors in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study.Journal of cancer survivorship : research and practice · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundPatients with chronic conditions are treated by many providers, which can increase the risk of communication gaps across providers and potential harm to patients. However, to the authors' knowledge, the extent of fragmented care among this population is unknown. In the current study, the authors sought to determine whether cancer survivors have more fragmented care than noncancer controls and to quantify the extent of fragmentation.
methodsData from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study linked to Medicare claims were used. The authors included beneficiaries with continuous Part A and B coverage for 12 months at the time of their baseline REGARDS survey. The primary outcome of the current study was claims-based fragmentation over 12 months, which was calculated using the reversed Bice-Boxerman Index so a higher score reflected greater fragmentation. Unadjusted differences in fragmentation were compared between cancer survivors and controls. Beta regression models were used to estimate associations between cancer status and fragmentation, adjusting for potential confounders.
resultsThe authors included 4922 participants aged ≥65 years at baseline. Of these patients, approximately 21% were cancer survivors. Survivors had a median of 11 visits (interquartile range, 7-15 visits) with 5 providers compared with controls, who had a median of 9 visits (interquartile range, 6-14 visits) with 4 providers (P < .0001). Cancer survivors had significantly more fragmented care compared with controls (median reversed Bice-Boxerman Index, 0.80 vs 0.76; P < .0001). After adjusting for confounders, cancer survivors had an increased odds of having fragmented care (odds ratio, 1.08; 95% CI, 1.02-1.14).
conclusionsCare fragmentation is more prevalent among cancer survivors compared with those without a history of cancer. Future studies should examine whether fragmentation puts survivors at risk of worse outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.