To date, research on barriers to care has largely focussed on influences affecting the utilization of services (economic, cultural, social psychological, organizational, and geographic): few studies have examined reasons for variability in care a at later stage in the process, after utilization has occurred (i.e., during the patient-provider encounter). The proposed study will fill knowledge gaps by; (a) identifying within the context of the patient-provider relationship, barriers to appropriate diagnosis and treatment of symptomatic breast cancer in women aged 65 years and over; and (b) evaluating a specific patient intervention designed to remove these identified barriers. Physicians' evaluations of patients' presenting symptoms are generally thought to be relatively free of extraneous influences and guided by biomedical criteria. However, prior research suggests that patient sociodemographics and personal characteristics of physicians influence physician preferences. Since physicians are gatekeepers to costly treatment and technology required to care for older people, it is important for effective case management and public policy to disentangle the factors influencing physician preference in diagnosis and treatment of older women with breast cancer.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
1R01AG011352-01
Application #
3123297
Study Section
Special Emphasis Panel (SRC (62))
Project Start
1992-09-21
Project End
1995-08-31
Budget Start
1992-09-21
Budget End
1993-08-31
Support Year
1
Fiscal Year
1992
Total Cost
Indirect Cost
Name
New England Research Institute
Department
Type
DUNS #
153914080
City
Watertown
State
MA
Country
United States
Zip Code
02472
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McKinlay, J B; Burns, R B; Durante, R et al. (1997) Patient, physician and presentational influences on clinical decision making for breast cancer: results from a factorial experiment. J Eval Clin Pract 3:23-57
Durante, R; McKinlay, J B; Kasten, L et al. (1997) The influences of patient characteristics and physician experience on case recall. Med Decis Making 17:199-207
Feldman, H A; McKinlay, J B; Potter, D A et al. (1997) Nonmedical influences on medical decision making: an experimental technique using videotapes, factorial design, and survey sampling. Health Serv Res 32:343-66
Burns, R B; Freund, K M; Moskowitz, M A et al. (1997) Physician characteristics: do they influence the evaluation and treatment of breast cancer in older women? Am J Med 103:263-9