Physician peer group characteristics and timeliness of breast cancer surgery

Jacqueline Bachand, Pamela R. Soulos, Jeph Herrin, Craig Pollack, Xiao Xu, Xiaomei Ma, Cary P. Gross

Research output: Contribution to journalArticle

Abstract

Purpose: Little is known about how the structure of interdisciplinary groups of physicians affects the timeliness of breast cancer surgery their patients receive. We used social network methods to examine variation in surgical delay across physician peer groups and the association of this delay with group characteristics. Methods: We used linked Surveillance, Epidemiology, and End Results-Medicare data to construct physician peer groups based on shared breast cancer patients. We used hierarchical generalized linear models to examine the association of three group characteristics, patient racial composition, provider density (the ratio of potential vs. actual connections between physicians), and provider transitivity (clustering of providers within groups), with delayed surgery. Results: The study sample included 8338 women with breast cancer in 157 physician peer groups. Surgical delay varied widely across physician peer groups (interquartile range 28.2–50.0%). For every 10% increase in the percentage of black patients in a peer group, there was a 41% increase in the odds of delayed surgery for women in that peer group regardless of a patient’s own race [odds ratio (OR) 1.41, 95% confidence interval (CI) 1.15–1.73]. Women in physician peer groups with the highest provider density were less likely to receive delayed surgery than those in physician peer groups with the lowest provider density (OR 0.65, 95% CI 0.44–0.98). We did not find an association between provider transitivity and delayed surgery. Conclusions: The likelihood of surgical delay varied substantially across physician peer groups and was associated with provider density and patient racial composition.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalBreast Cancer Research and Treatment
DOIs
StateAccepted/In press - Apr 24 2018

Fingerprint

Peer Group
Breast Neoplasms
Physicians
Odds Ratio
Women Physicians
Confidence Intervals
Group Structure
Medicare
Social Support
Cluster Analysis
Linear Models
Epidemiology

Keywords

  • Breast cancer care
  • Network density
  • Network transitivity
  • Surgery delay

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Physician peer group characteristics and timeliness of breast cancer surgery. / Bachand, Jacqueline; Soulos, Pamela R.; Herrin, Jeph; Pollack, Craig; Xu, Xiao; Ma, Xiaomei; Gross, Cary P.

In: Breast Cancer Research and Treatment, 24.04.2018, p. 1-9.

Research output: Contribution to journalArticle

Bachand, Jacqueline ; Soulos, Pamela R. ; Herrin, Jeph ; Pollack, Craig ; Xu, Xiao ; Ma, Xiaomei ; Gross, Cary P. / Physician peer group characteristics and timeliness of breast cancer surgery. In: Breast Cancer Research and Treatment. 2018 ; pp. 1-9.
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