, Volume 24, Issue 2 Supplement, pp 472-479
Date: 18 Oct 2009

Follow-up Care Delivery Among Colorectal Cancer Survivors Most Often Seen by Primary and Subspecialty Care Physicians

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Abstract

Background

The Institute of Medicine has identified patients as a key source of information for assessing the quality of care.

Objective

To evaluate the association of physician specialty with the content and quality of follow-up cancer care.

Design and Participants

Three hundred three colorectal cancer (CRC) survivors in Northern California were surveyed 2–5 years post-diagnosis.

Measurements

Specialty of physician seen most often [primary care physician (PCP), oncologist, surgeon, or gastroenterologist]; other physician specialties seen; patient characteristics; content of visits; patient-centered quality of follow-up care (communication, coordination, nursing, and staff interactions).

Main Results

A minority (16%) of CRC survivors reported that the doctor they most often saw for follow-up cancer care was a PCP, while 60% saw an oncologist. Many CRC survivors (40%) saw >1 physician for follow-up cancer care. Survivors most often seen by PCPs were more likely to have three or more medical comorbidities (70% vs. 51%, p = 0.012) than survivors seen by subspecialty physicians. Survivors seen by PCPs were less likely to report seeing a doctor for medical tests and more likely to report discussing disease prevention (82% vs. 64%, p = 0.012) or diet (70% vs. 48%, p = 0.005) with their doctor. There were no significant specialty differences in patient-centered quality of follow-up cancer care.

Conclusions

Cancer survivors’ assessment of the quality of care was similar across specialties, while the content of follow-up cancer care varied by physician specialty. These findings provide important information about the potential value of primary care and the need for coordination when delivering care to CRC survivors.