Table 3.
Multivariable adjusted linear regression for composite measures and single-rating items associated with breast cancer tumor characteristics among female breast cancer survivors in SEER-CAHPS 2000–2019 completing a CAHPS survey post-diagnosis stratified by race/ethnicity
| OUTCOMES PREDICTOR | Stratification: race/ethnicity | p-int. (predictor x NHB) | p-int. (predictor x NHA) | p-int. (predictor x Hispanic) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NHW (N = 12,528) | NHB (N = 1332) | NHA (N = 1020) | Hispanic (N = 1001) | ||||||||||||
| N | β (SE) | p | N | β (SE) | p | N | β (SE) | p | N | β (SE) | p | ||||
| Getting care quickly (N = 15,881) | |||||||||||||||
| Extent of disease: Localized (ref) | |||||||||||||||
| Regional | 2090 | 0.35 (0.58) | 0.54 | 245 | 0.34 (2.05) | 0.86 | 208 | − 1.98 (2.09) | 0.34 | 223 | 2.37 (2.14) | 0.26 | 0.78 | 0.66 | 0.32 |
| Distant | 264 | − 0.61 (1.42) | 0.66 | 34 | 1.53 (4.88) | 0.75 | 14 | 1.51 (6.97) | 0.82 | 18 | − 6.14 (6.27) | 0.32 | 0.96 | 0.71 | 0.27 |
| ER status: ER + (ref) | |||||||||||||||
| ER− | 1096 | − 0.06 (0.74) | 0.93 | 234 | − 0.01 (2.20) | 0.99 | 151 | − 0.23 (2.33) | 0.94 | 123 | 1.58 (2.61) | 0.61 | 0.77 | 0.66 | 0.32 |
| Missing/Unknown | 4284 | 0.12 (0.72) | 0.85 | 417 | − 0.54 (2.57) | 0.83 | 128 | − 7.77 (2.90) | 0.007 | 273 | − 2.42 (2.76) | 0.38 | 0.95 | 0.70 | 0.27 |
| Getting needed care (N = 14,472) | |||||||||||||||
| Extent of disease: Localized (ref) | |||||||||||||||
| Regional | 1950 | 1.12 (0.50) | 0.02 | 215 | 2.82 (1.88) | 0.13 | 189 | − 1.58 (1.98) | 0.42 | 202 | − 0.76 (2.00) | 0.70 | 0.32 | 0.23 | 0.67 |
| Distant | 254 | 1.44 (1.22) | 0.23 | 30 | − 4.43 (4.47) | 0.32 | 12 | − 8.54 (6.71) | 0.20 | 18 | − 6.05 (5.66) | 0.28 | 0.10 | 0.09 | 0.26 |
| ER status: ER + (ref) | |||||||||||||||
| ER− | 1021 | 0.41 (0.65) | 0.52 | 199 | 4.12 (2.03) | 0.04 | 137 | − 1.76 (2.19) | 0.42 | 107 | − 1.77 (2.49) | 0.47 | 0.33 | 0.24 | 0.68 |
| Missing/Unknown | 3907 | 0.67 (0.63) | 0.28 | 354 | − 0.11 (2.36) | 0.96 | 116 | − 3.28 (2.72) | 0.22 | 235 | − 2.95 (2.66) | 0.26 | 0.11 | 0.09 | 0.25 |
| Physician communication (N = 14,314) | |||||||||||||||
| Extent of disease: Localized (ref) | |||||||||||||||
| Regional | 1824 | 0.19 (0.42) | 0.64 | 231 | 1.38 (1.29) | 0.28 | 193 | − 0.88 (1.43) | 0.53 | 217 | 0.17 (1.36) | 0.89 | 0.38 | 0.64 | 0.60 |
| Distant | 240 | − 1.78 (1.02) | 0.08 | 27 | − 0.99 (3.34) | 0.76 | 12 | − 1.78 (4.93) | 0.71 | 19 | − 3.19 (3.83) | 0.40 | 0.82 | 0.86 | 0.91 |
| ER status: ER + (ref) | |||||||||||||||
| ER− | 970 | 0.10 (0.54) | 0.85 | 218 | − 0.18 (1.40) | 0.89 | 143 | 0.31 (1.57) | 0.84 | 111 | 0.68 (1.72) | 0.69 | 0.40 | 0.63 | 0.62 |
| Missing/Unknown | 3941 | − 0.57 (0.52) | 0.27 | 390 | − 1.95 (1.64) | 0.23 | 116 | − 2.10 (2.00) | 0.29 | 248 | − 1.76 (1.75) | 0.31 | 0.85 | 0.88 | 0.92 |
| Getting needed prescription drugs (N = 13,137) | |||||||||||||||
| Extent of disease: Localized (ref) | |||||||||||||||
| Regional | 1651 | 0.15 (0.50) | 0.75 | 219 | 1.16 (1.59) | 0.46 | 179 | − 0.39 (1.70) | 0.81 | 199 | 1.22 (1.84) | 0.50 | 0.21 | 0.91 | 0.27 |
| Distant | 228 | − 0.62 (1.18) | 0.59 | 33 | − 2.83 (3.63) | 0.43 | 15 | − 5.51 (5.03) | 0.27 | 18 | − 1.46 (5.15) | 0.77 | 0.54 | 0.31 | 0.87 |
| ER status: ER + (ref) | |||||||||||||||
| ER− | 879 | − 0.49 (0.64) | 0.43 | 193 | 0.33 (1.77) | 0.84 | 139 | − 0.86 (1.83) | 0.63 | 108 | 0.03 (2.29) | 0.98 | 0.24 | 0.85 | 0.82 |
| Missing/Unknown | 3702 | 1.24 (0.62) | 0.04 | 378 | − 1.97 (2.01) | 0.32 | 120 | − 2.00 (2.24) | 0.37 | 265 | − 2.75 (2.32) | 0.23 | 0.25 | 0.63 | 0.05 |
| Overall care rating (N = 15,957) | |||||||||||||||
| Extent of disease: Localized (ref) | |||||||||||||||
| Regional | 2094 | 0.34 (0.39) | 0.38 | 248 | 3.13 (1.47) | 0.03 | 219 | − 1.18 (1.41) | 0.40 | 224 | 2.64 (1.56) | 0.09 | 0.04 | 0.32 | 0.23 |
| Distant | 271 | − 1.26 (0.95) | 0.18 | 31 | − 0.60 (3.70) | 0.87 | 14 | − 0.27 (4.80) | 0.95 | 19 | − 7.01 (4.48) | 0.11 | 0.90 | 0.81 | 0.10 |
| ER status: ER + (ref) | |||||||||||||||
| ER− | 1105 | 0.02 (0.50) | 0.95 | 228 | − 2.05 (1.60) | 0.20 | 157 | − 0.01 (1.58) | 0.99 | 125 | 2.10 (1.90) | 0.26 | 0.05 | 0.31 | 0.24 |
| Missing/Unknown | 4307 | − 0.42 (0.49) | 0.39 | 413 | − 0.05 (1.89) | 0.97 | 126 | − 4.58 (1.98) | 0.02 | 277 | − 1.39 (2.03) | 0.49 | 0.88 | 0.80 | 0.10 |
| Health plan rating (N = 16,432) | |||||||||||||||
| Extent of disease: Localized (ref) | |||||||||||||||
| Regional | 2166 | 0.40 (0.42) | 0.34 | 259 | 2.29 (1.34) | 0.08 | 226 | 0.06 (1.38) | 0.96 | 232 | − 2.40 (1.39) | 0.08 | 0.06 | 0.86 | 0.10 |
| Distant | 275 | 0.47 (1.04) | 0.64 | 33 | − 0.26 (3.30) | 0.93 | 15 | − 3.02 (4.60) | 0.51 | 21 | − 1.26 (3.94) | 0.74 | 0.73 | 0.30 | 0.83 |
| ER status: ER + (ref) | |||||||||||||||
| ER− | 1134 | − 0.35 (0.55) | 0.52 | 241 | − 1.13 (1.45) | 0.43 | 157 | 0.87 (1.56) | 0.57 | 129 | 1.37 (1.72) | 0.42 | 0.06 | 0.86 | 0.11 |
| Missing/Unknown | 4433 | 0.50 (0.53) | 0.34 | 421 | − 0.98 (1.70) | 0.56 | 131 | − 4.31 (1.90) | 0.02 | 290 | 0.02 (1.78) | 0.98 | 0.73 | 0.30 | 0.83 |
| Physician rating (N = 14,354) | |||||||||||||||
| Extent of disease: Localized (ref) | |||||||||||||||
| Regional | 1837 | 0.38 (0.38) | 0.31 | 232 | 3.47 (1.19) | 0.004 | 191 | − 0.91 (1.24) | 0.46 | 212 | − 0.61 (1.39) | 0.65 | 0.02 | 0.41 | 0.19 |
| Distant | 236 | − 2.13 (0.93) | 0.02 | 24 | 0.57 (3.27) | 0.86 | 12 | 3.01 (4.24) | 0.47 | 18 | − 0.35 (3.99) | 0.92 | 0.47 | 0.39 | 0.58 |
| ER status: ER + (ref) | |||||||||||||||
| ER− | 977 | − 0.41 (0.49) | 0.40 | 219 | 0.14 (1.30) | 0.91 | 141 | − 0.29 (1.36) | 0.83 | 109 | 0.38 (1.76) | 0.82 | 0.67 | 0.92 | 0.91 |
| Missing/Unknown | 3956 | − 0.33 (0.47) | 0.47 | 379 | 1.24 (1.53) | 0.41 | 115 | − 3.12 (1.72) | 0.07 | 246 | − 1.90 (1.78) | 0.28 | 0.19 | 0.002 | 0.17 |
CAHPS Consumer assessment of healthcare providers and systems, ER estrogen receptor, int. interaction, NHA non-Hispanic Asian or Pacific Islander, NHB non-Hispanic Black or African American, NHW non-Hispanic white, SE standard error, SEER Surveillance, epidemiology, and end results program
Missing values: Getting care quickly composite (2963); Getting needed care composite (4379); Physician communication composite (4548); Getting needed prescription drugs composite (5722); Overall care rating (2890); Health plan rating (2402); Physician rating (4509); race/ethnicity (194)
Case-mix adjustments for years 1999–2019: Age at CAHPS survey (65–69, 70–74, 75–79, 80–84, ≥ 85); Education (< high school, high school graduate/GED/some college, college graduate); General health status (excellent/very good, good, fair/poor); Received help responding (no, yes); Proxy answered questions for respondent (no, yes)
Additional adjusted covariates: age at diagnosis (continuous); Mental health status (excellent/very good; good; fair/poor; missing); years from diagnosis to CAHPS survey (continuous); Centers for Medicare & Medicaid Services (CMS) multimorbidity (continuous); CAHPS survey year (continuous); area-level poverty (0– < 20% poverty; 20–100% poverty; unknown/missing); Medicare plan type (other [prescription drug plan {PDP} or Medicare Advantage {MA}], fee-for-service Medicare)
Borderline cases for ER status (13) were excluded
Predictors and stratifications are mutually adjusted
Bold font indicates statistically significant with corresponding p < .05