ArticleJCO global oncology2023
Fragmentation of Care and Its Association With Survival and Costs for Patients With Breast Cancer in Colombia.
Article in JCO global oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- 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
- Clinical and prognostic factors in pleural mesothelioma: insights from a Latin American cohort.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Digital Support for Cancer Caregivers in Latin America: Identifying Needs and Co-Designing a Culturally Adapted Resource.Psycho-oncology · 2026Article
- Difficulties with clinical practice guidelines for congenital syphilis prevention in Colombia: a qualitative study.BMC infectious diseases · 2026Article
- Medicaid Expansion and Overall Mortality Among Women With Breast Cancer.JAMA network open · 2026Article
- Assessing perceived needs for telepathology implementation in Colombia: a baseline study from Red GLORIA.Frontiers in digital health · 2026Article
- Mortality and comorbidities among teaching professionals: A cross-sectional study in Colombia.PloS one · 2026Article
- 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
- Quality of care in Colombian women with early-onset breast cancer in two time periods: findings from a nationwide administrative registry cohort.Lancet regional health. Americas · 2025Article
- Prevalence, comorbidities, and disease-related complications of rheumatoid arthritis in Colombia: a national cross-sectional study based on administrative claims data.Advances in rheumatology (London, England) · 2025Observational
- Article
- The invisible frontline: experiences of public health workers during the COVID-19 pandemic and health emergencies in Colombia.Frontiers in public health · 2025Article
- Association of healthcare fragmentation with three-year survival among kidney transplant recipients in Colombia.PloS one · 2025Article
- Socioeconomic inequalities of 3-year survival in formal employees with colorectal cancer between 2012 and 2019 in Colombia.PloS one · 2025Article
- Fragmentation of care in breast cancer: greater than the sum of its parts.Breast cancer research and treatment · 2024Article
- Survival among patients with untreated metastatic breast cancer: "What if I do nothing?"Breast cancer research and treatment · 2024Article
- Stage III Non-small Cell Lung Cancer Resectability in a Country With Limited Diagnostic and Therapeutic Resources: A Colombian Expert Consensus.Cancer control : journal of the Moffitt Cancer CenterArticle
- Survival Outcomes of Metastatic Non-small Cell Lung Cancer Patients With Limited Access to Immunotherapy and Targeted Therapy in a Cancer Center of a Low- and Middle-Income Country.Cancer control : journal of the Moffitt Cancer CenterArticle
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
purposeBreast cancer care requires a multimodal approach and a multidisciplinary team who must work together to obtain good clinical results. The fragmentation of care can affect the breast cancer care; however, it has not been measured in a low-resource setting. The aim of this study was to identify fragmentation of care, the geographic variation of this and its association with 4-year overall survival (OS), and costs of care for patients with breast cancer enrolled in Colombia's contributory health care system. MATERIALS AND
methodsA retrospective cohort study was conducted using administrative databases. Women with breast cancer who were treated from January 1, 2013, to December 31, 2015, were included. Fragmentation of care was the exposure, which was measured by the number of different health care provider institutions (HCPIs) that treated a patient during the first year after diagnosis. Crude mortality rates were estimated, survival functions were calculated using the nonparametric Kaplan-Meier approach, and adjusted hazard ratios (HRs) were estimated using multivariate Cox regression model to identify the association of fragmentation with 4-year OS. The association between fragmentation and costs of care was assessed using a multivariate linear regression model.
resultsA total of 10,999 patients with breast cancer were identified, and 1,332 deaths were observed. The 4-year crude mortality rate was 31.97 (95% CI, 30.25 to 33.69) per 1,000 person-years for the whole cohort, and the highest rate was in the cohort defined for the fourth quartile of the fragmentation measurement (eight or more HCPIs), 40.94 (95% CI, 36.49 to 45.39). The adjusted HR for 4-year OS was 1.04 (95% CI, 1.01 to 1.07) for each HCPI additional. The cost of care is increased for each additional HCPIs (cost ratio, 1.25; 95% CI, 1.23 to 1.26).
conclusionFragmentation of care decreases overall 4-year OS and increases the costs of care in women with breast cancer for Colombia.
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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.