ArticleJCO oncology practice2021
Fragmentation of Care Among Black Women With Breast Cancer and Comorbidities: The Role of Health Systems.
Article in JCO oncology practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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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.
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Who cites it
19 citing papers in PubMed, 23 citations in OpenAlex.
- Equity-Oriented Design Processes and Evaluation of Digital Health Technologies for Black Communities Beyond Usability: Scoping Review.Journal of medical Internet research · 2026Article
- Balancing cancer and comorbidity: a multicenter qualitative study on how comorbidity shapes survivorship care preferences in China.Journal of cancer survivorship : research and practice · 2026Article
- Examining Barriers to Cancer Care: A Needs Assessment of African American and Black African Immigrants in Iowa.Journal of racial and ethnic health disparities · 2026Article
- Regional Inequities in Mammography Access and Utilization in Latin America: Ethnic, Rural, and Structural Barriers Identified Through a Narrative Review.Epidemiologia (Basel, Switzerland) · 2026Review
- Racial and Ethnic Differences in Diabetes Care Quality in A National Sample of Cancer Survivors Relative to Non-Cancer Controls.Journal of racial and ethnic health disparities · 2025Article
- Impact of fragmented care on cancer outcomes among korean women with breast and cervical cancer: a focus on regional and economic disparities.International journal for equity in health · 2025Article
- Data-driven insights into interhospital care fragmentation: Implications for health policy and equity among older adults.PloS one · 2025Article
- Fragmentation of care in breast cancer: greater than the sum of its parts.Breast cancer research and treatment · 2024Article
- Health Care Contact Days Among Older Cancer Survivors.JCO oncology practice · 2024Article
- Survival among patients with untreated metastatic breast cancer: "What if I do nothing?"Breast cancer research and treatment · 2024Article
- National Breast, Cervical, and Colorectal Cancer Screening Use in Federally Qualified Health Centers.JAMA internal medicine · 2024Article
- Consuming Patients' Days: Time Spent on Ambulatory Appointments by People With Cancer.The oncologist · 2024Article
- Health Care Contact Days Experienced by Decedents With Advanced GI Cancer.JCO oncology practice · 2023Article
- Racial Disparities in Breast Cancer Treatments and Adverse Events in the SEER-Medicare Data.Cancers · 2023Article
- Health insurance and neighborhood poverty as mediators of racial disparities in advanced disease stage at diagnosis and nonreceipt of surgery for women with breast cancer.Cancer medicine · 2023Article
- "There's not enough studies": Views of black breast and ovarian cancer patients on research participation.Cancer medicine · 2023Article
- Multi-institutional Care in Clinical Stage II and III Esophageal Cancer.The Annals of thoracic surgery · 2023Article
- Patterns and Impact of Fragmented Care in Stage II and III Gastric Cancer.Annals of surgical oncology · 2022Article
- Health Equity: The Only Path Forward for Primary Care.Annals of family medicineArticle
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
purposeBlack women are disproportionately burdened by comorbidities and breast cancer. The complexities of coordinating care for multiple health conditions can lead to adverse consequences. Care coordination may be exacerbated when care is received outside the same health system, defined as care fragmentation. We examine types of practice setting for primary and breast cancer care to assess care fragmentation. MATERIALS AND
methodsWe analyzed data from a prospective cohort of Black women diagnosed with breast cancer in New Jersey who also had a prior diagnosis of diabetes and/or hypertension (N = 228). Following breast cancer diagnosis, we examined types of practice setting for first primary care visit and primary breast surgery, through medical chart abstraction, and identified whether care was used within or outside the same health system. We used multivariable logistic regression to explore sociodemographic and clinical factors associated with care fragmentation.
resultsDiverse primary care settings were used: medical groups (32.0%), health systems (29.4%), solo practices (23.7%), Federally Qualified Health Centers (8.3%), and independent hospitals (6.1%). Surgical care predominately occurred in health systems (79.8%), with most hospitals being Commission on Cancer-accredited. Care fragmentation was experienced by 78.5% of Black women, and individual-level factors (age, health insurance, cancer stage, and comorbidity count) were not associated with care fragmentation (
conclusionThe majority of Black breast cancer survivors with comorbidities received primary care and surgical care in different health systems, illustrating care fragmentation. Strategies for care coordination and health care delivery across health systems and practice settings are needed for health equity.
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