The Breast Care Center: Innovative Care for the Underserved
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Minority, low-income, and medically underserved women are at higher risk of dying from breast cancer than women from less disadvantaged groups. These adverse differences in survival rates have been linked in part to delays by some women in these groups in obtaining care and to not following through with medical recommendations. Delays and missed treatments have been linked in turn to institutional, economic, social, cultural, and linguistic barriers that can impede these patients’ access to care and limit the ability of providers to deliver quality services in a way that effectively addresses the patients’ multiplicity of needs.
 
 
 
 
 
 
 
 We propose to conduct a comparative evaluation of an innovative organizational model - the Breast Care Center (BCC) - for improving the delivery of breast cancer control services to underserved women. A BCC is a "one stop" center that provides all of the outpatient services essential to breast cancer care and organizes them to ensure maximum efficiency and timeliness. It brings together the full range of cancer-related medical specialties and social services, and supports and tracks patients through all phases of cancer control: patient education; screening; timely resolution or diagnosis; prompt initiation of treatment; long-term follow-up; and patient support services. Although this model’s effectiveness has been established in university and private hospitals, it has rarely been used, and never adequately evaluated, in facilities providing care to underserved patients.
 
 
 
 
 
 
 
 This study is a collaboration among four public hospitals in San Francisco Bay Area counties. Two of them utilize the BCC model and two, which will serve as control sites, do not. We will examine whether county hospitals providing care to breast cancer patients through the BCC model, compared to county hospitals providing traditionally organized care, offer more comprehensive and coordinated services; provide more appropriate and timely care; track patient progress better; produce greater patient satisfaction with care; and achieve better patient adherence to treatment recommendations. Our aims are to: (1) document how the BCC concept is implemented in two county hospitals, to assess the extent to which BCC goals are being met, and to identify institutional barriers to meeting these goals; (2) test the hypothesis cited above; and (3) use study data to develop a comprehensive BCC model and evaluation procedures for the four-county area and other areas serving multicultural underserved women.
 
 
 
 
 
 
 
 We will identify points in the health care continuum at which institutional barriers impede patients’ access to quality care, and examine the impact of the BCC model on alleviating those barriers. We will also establish a comprehensive system for collecting and managing data on breast cancer in the four-county study area to facilitate this and future research.
 
 
 
 
 
 
 
 We expect that underserved patients using the BCC will find it easier to access needed services, obtain quality care, and adhere to medical recommendations. By promoting early detection and facilitating diagnosis, treatment, and follow-up, the model has a strong potential to address barriers to successful outcomes and improve survival rates for the most vulnerable segments of our population.