Continuity of Care, Follow-Up Care, and Outcomes among Breast Cancer Survivors

Abstract

This retrospective cohort study examined the effects of care continuity on the utilization of follow-up services and outcome of breast cancer patients (stages I–III) in the post-treatment phase of care. Propensity score matching and generalized estimation equations were used in the analysis of data obtained from national longitudinal databases. The continuity of care index (COCI) was calculated separately for primary care physicians (PCP) and oncologists. Our results revealed that breast cancer survivors with a higher oncology COCI were more likely than those with a lower oncology COCI to use mammography or breast ultrasound during the follow-up period (OR = 1.26, 95% CI: 1.19–1.32; OR = 1.12, 95% CI: 1.06–1.18; respectively). In terms of health outcomes, a higher oncology COCI was associated with a lower likelihood of hospitalization (OR = 0.78, 95% CI: 0.71–0.85) and emergency department use (OR = 0.88, 95% CI: 0.82–0.95). A higher PCP COCI was also associated with a lower likelihood of hospitalization (OR = 0.77, 95% CI: 0.70–0.85) and emergency department use (OR = 0.75, 95% CI: 0.68–0.82). Overall, this study determined that ambulatory care continuity is positively associated with the likelihood of using recommended follow-up care services and negatively associated with adverse health events among breast cancer survivors.

Adherence of long-term breast cancer survivors to follow-up care guidelines: a study based on real-world data from the SURBCAN cohort

“…Non-adherence was even higher when imaging was limited to mammograms. This study is the first to analyze adherence with realworld data among Spanish LTBCS, and the results are in line with those of studies performed in other contexts [21][22][23][26][27][28][29][30][31].…”

Effect of Continuity of Care on Chronic Diseases

“…Higher care continuity is linked to improved mental health, a stronger sense of happiness, and a higher quality of life, as per the previous research studies. However, poor continuity of care is linked to the overuse of medical resources, particularly through the use of needless services (8). Chan et al described that compared to health indicators like HbA1c and blood pressure, the positive impacts of continuity of care were reported more frequently for service utilization, mortality, and diseaserelated sequelae.…”

Effect of WeChat‐based continuous care intervention on the somatic function, depression, anxiety, social function and cognitive function for cancer patients: Meta‐analysis of 18 RCTs

“…This involves inpatient care that extends to the treatment and rehabilitation of patients after discharge, helping to improve patient self‐management and ensuring uninterrupted information, treatment and care services (Hirschman et al, 2015; Liu et al, 2015). For patients with cancer, reasonable out‐of‐hospital health guidance can, to a certain extent, change poor health behaviours, reduce the likelihood of hospital readmission (Chen et al, 2019), and reduce the mortality rate of cancer patients (Justiniano et al, 2019), which is one of the important measures of tertiary cancer prevention. Compared to routine discharge follow‐up care, continuous care can prevent postoperative cancer fatigue (Huanzhi et al, 2017) and reduce anxiety and depression in cancer patients (Yingying et al, 2019).…”