Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Kranz, Ashley M. ; Ryan, Jamie ; Mahmud, Ammarah ; Setodji, Claude Messan ; Damberg, Cheryl L. ; Timbie, Justin W.
• Description:
  Introduction
  
  Primary care providers who lack reliable referral relationships with specialists may be less likely than those who do have such relationships to conduct cancer screenings. Community health centers (CHCs), which provide primary care to disadvantaged populations, have historically reported difficulty accessing specialty care for their patients. This study aimed to describe strategies CHCs use to integrate care with specialists and examine whether more strongly integrated CHCs have higher rates of screening for colorectal and cervical cancers and report better communication with specialists.
  
  Methods
  
  Using a 2017 survey of CHCs in 12 states and the District of Columbia and administrative data, we estimated the association between a composite measure of CHC/specialist integration and 1) colorectal and cervical cancer screening rates, and 2) 4 measures of CHC/specialist communication using multivariate regression models.
  
  Results
  
  Integration strategies commonly reported by CHCs included having specialists deliver care on-site (80%) and establishing referral agreements with specialists (70%). CHCs that were most integrated with specialists had 5.6 and 6.8 percentage-point higher colorectal and cervical cancer screening rates, respectively, than the least integrated CHCs (P < .05). They also had significantly higher rates of knowing that specialist visits happened (67% vs 42%), knowing visit outcomes (65% vs 42%), receiving information after visits (47% vs 21%), and timely receipt of information (44% vs 27%).
  
  Conclusion
  
  CHCs use various strategies to integrate primary and specialty care. Efforts to promote CHC/specialist integration may help increase rates of cancer screening.
  
  
• Subjects:
  Original Research
• Source:
  Prev Chronic Dis. 2020; 17
• ISSN:
  1545-1151
• Pubmed ID:
  33119485
• Pubmed Central ID:
  PMC7665578
• Document Type:
  Journal Article
• Volume:
  17
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:df94d1ddec160fe4af17e725fc70298b52231bd9f51c8e9ec6c04a2b32182dbe477211e44e15f1609488308ebf5cde06aba6244d9e67e3b5a6598401be03a1a4
• Download URL:
  https://stacks.cdc.gov/view/cdc/97436/cdc_97436_DS1.pdf
• File Type:
  [PDF - 507.01 KB ]