Minimal increase in use of breast-conserving surgery from 1986 to 1990. Med Care 1996 May;34(5):479-89
Date
05/01/1996Pubmed ID
8614169DOI
10.1097/00005650-199605000-00009Scopus ID
2-s2.0-0030136723 (requires institutional sign-in at Scopus site) 80 CitationsAbstract
Substantial geographic and hospital-based variations have been documented in the use of breast-conserving surgery (BCS) in 1986. The authors studied the patterns of adoption of this procedure from 1986 to 1990. National Medicare inpatient claims were used to study women aged 65 to 79 who underwent an operation for local or regional breast cancer in 1986 (38,679 patients) or 1990 (43,083 patients). Breast-conserving surgery was used for 5,509 (14.1%) of the Medicare patients in 1986 and 6,476 (15.0%) in 1990. The only region with an increase in BCS use from 1986 to 1990 was New England. Many hospitals had low volumes of operations, with a median of six to seven patients annually. Ten percent of the hospitals performed 55% of the conservative operations. Large hospitals, urban hospitals, and those with higher patient volumes or a cancer center were somewhat more likely to have increased use of BCS by 1990. Despite the substantial evidence supporting BCS as an alternative to mastectomy, the overall use of BCS in Medicare inpatients increased minimally from 1986 to 1990. Many patients are treated in hospitals with little experience with BCS. Hospitals using more BCS in 1986 were somewhat more likely to increase the use of BCS by 1990.
Author List
Nattinger AB, Gottlieb MS, Hoffman RG, Walker AP, Goodwin JSAuthors
Ann B. Nattinger MPH, MD Vice Dean, Associate Provost, Professor in the Medicine department at Medical College of WisconsinAlonzo Walker MD Emeritus Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedBreast Neoplasms
Cross-Sectional Studies
Databases, Factual
Diffusion of Innovation
Female
Hospitals
Humans
Mastectomy
Medicare Part A
Multivariate Analysis
Practice Patterns, Physicians'
United States
