Table 6.
Multivariable adjusted linear regression for composite measures and single-item ratings associated with breast cancer treatment among female breast cancer survivors in SEER-CAHPS 2000–2019 completing a CAHPS survey post-diagnosis stratified by education
| OUTCOMES PREDICTOR | Stratification: Education | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| < High School (N = 2673) | High School/GED/Some College (N = 10,980) | College Graduate (N = 4217) | p-int. (predictor x HS/GED/Some College) | p-int. (predictor x College Graduate) | |||||||
| N | β (SE) | p-value | N | β (SE) | p-value | N | β (SE) | p-value | |||
| Getting Care Quickly (N = 15,024) | |||||||||||
| Chemotherapy: No/Unknown (ref) | |||||||||||
| Chemotherapy | 348 | − 3.85 (1.72) | 0.02 | 1806 | 0.35 (0.71) | 0.61 | 764 | 3.09 (1.06) | 0.004 | 0.005 | 0.004 |
| Missing | 605 | 1.46 (3.01) | 0.62 | 2322 | 0.40 (1.36) | 0.76 | 857 | 0.55 (2.09) | 0.79 | 0.16 | 0.26 |
| Radiation: No/Unknown (ref) | |||||||||||
| Radiation | 752 | − 0.45 (1.31) | 0.72 | 3867 | 0.26 (0.57) | 0.63 | 1619 | 0.34 (0.86) | 0.69 | 0.45 | 0.44 |
| Missing | 605 | 8.26 (3.81) | 0.03 | 2322 | 0.23 (1.60) | 0.88 | 857 | − 4.93 (2.45) | 0.04 | 0.10 | 0.16 |
| Getting needed care (N = 13,787) | |||||||||||
| Chemotherapy: No/Unknown (ref) | |||||||||||
| Chemotherapy | 322 | 1.28 (1.61) | 0.42 | 1661 | 0.69 (0.60) | 0.25 | 731 | 2.05 (0.97) | 0.03 | 0.68 | 0.67 |
| Missing | 530 | 4.98 (2.83) | 0.07 | 2100 | − 0.61 (1.16) | 0.59 | 810 | − 5.75 (1.90) | 0.003 | 0.37 | 0.61 |
| Radiation: No/Unknown (ref) | |||||||||||
| Radiation | 685 | − 2.26 (1.22) | 0.06 | 3526 | 0.52 (0.48) | 0.27 | 1547 | 2.43 (0.79) | 0.002 | 0.01 | 0.001 |
| Missing | 530 | − 2.13 (3.56) | 0.55 | 2100 | − 0.94 (1.36) | 0.49 | 810 | − 5.00 (2.25) | 0.02 | 0.85 | 0.31 |
| Physician communication (N = 13,589) | |||||||||||
| Chemotherapy: No/Unknown (ref) | |||||||||||
| Chemotherapy | 335 | − 0.42 (1.18) | 0.71 | 1620 | 0.41 (0.49) | 0.39 | 650 | 1.09 (0.81) | 0.17 | 0.08 | 0.06 |
| Missing | 580 | 1.21 (2.05) | 0.55 | 2151 | 0.97 (0.94) | 0.29 | 749 | 1.47 (1.59) | 0.35 | 0.55 | 0.07 |
| Radiation: No/Unknown (ref) | |||||||||||
| Radiation | 710 | 0.28 (0.89) | 0.75 | 3470 | − 0.03 (0.39) | 0.92 | 1381 | 0.62 (0.66) | 0.34 | 0.72 | 0.77 |
| Missing | 580 | 2.63 (2.59) | 0.30 | 2151 | 0.06 (1.11) | 0.95 | 749 | 0.52 (1.87) | 0.77 | 0.96 | 0.17 |
| Getting needed prescription drugs (N = 12,614) | |||||||||||
| Chemotherapy: No/Unknown (ref) | |||||||||||
| Chemotherapy | 323 | 0.97 (1.53) | 0.52 | 1523 | 0.05 (0.56) | 0.92 | 574 | 0.32 (0.97) | 0.73 | 0.65 | 0.38 |
| Missing | 594 | − 2.75 (2.68) | 0.30 | 2088 | 1.13 (1.08) | 0.29 | 723 | 0.35 (1.90) | 0.85 | 0.52 | 0.56 |
| Radiation: No/Unknown (ref) | |||||||||||
| Radiation | 678 | 0.93 (1.18) | 0.42 | 3202 | 0.34 (0.45) | 0.45 | 1199 | 0.50 (0.80) | 0.63 | 0.49 | 0.61 |
| Missing | 594 | − 2.82 (3.39) | 0.40 | 2088 | 1.71 (1.27) | 0.17 | 723 | 0.71 (2.26) | 0.75 | 0.70 | 0.60 |
| Overall care rating (N = 15,174) | |||||||||||
| Chemotherapy: No/Unknown (ref) | |||||||||||
| Chemotherapy | 353 | 0.59 (1.27) | 0.64 | 1839 | 0.65 (0.48) | 0.18 | 768 | 1.61 (0.66) | 0.01 | 0.65 | 0.40 |
| Missing | 613 | 1.29 (2.26) | 0.56 | 2365 | 0.44 (0.93) | 0.63 | 856 | − 1.61 (1.30) | 0.21 | 0.42 | 0.69 |
| Radiation: No/Unknown (ref) | |||||||||||
| Radiation | 733 | − 0.29 (0.97) | 0.76 | 3902 | 0.09 (0.38) | 0.80 | 1607 | 0.91 (0.53) | 0.08 | 0.72 | 0.34 |
| Missing | 613 | − 0.49 (2.80) | 0.86 | 2365 | − 0.67 (1.09) | 0.53 | 856 | − 3.00 (1.53) | 0.05 | 0.43 | 0.54 |
| Health plan rating (N = 15,682) | |||||||||||
| Chemotherapy: No/Unknown (ref) | |||||||||||
| Chemotherapy | 376 | 0.15 (1.21) | 0.90 | 1874 | 0.46 (0.50) | 0.35 | 765 | 0.35 (0.81) | 0.66 | 0.83 | 0.78 |
| Missing | 652 | 2.19 (2.11) | 0.30 | 2415 | 0.05 (0.95) | 0.95 | 865 | − 1.36 (1.58) | 0.38 | 0.42 | 0.83 |
| Radiation: No/Unknown (ref) | |||||||||||
| Radiation | 798 | − 1.25 (0.91) | 0.17 | 4041 | 0.07 (0.39) | 0.85 | 1618 | 0.99 (0.65) | 0.12 | 0.13 | 0.04 |
| Missing | 652 | − 0.61 (2.65) | 0.81 | 2415 | − 0.72 (1.13) | 0.52 | 865 | − 0.08 (1.86) | 0.96 | 0.18 | 0.22 |
| Physician rating (N = 13,635) | |||||||||||
| Chemotherapy: No/Unknown (ref) | |||||||||||
| Chemotherapy | 335 | − 1.82 (1.09) | 0.09 | 1626 | 0.26 (0.45) | 0.56 | 645 | 0.68 (0.71) | 0.33 | 0.02 | 0.03 |
| Missing | 576 | − 0.63 (1.92) | 0.74 | 2160 | 1.19 (0.86) | 0.16 | 747 | 0.14 (1.38) | 0.91 | 0.11 | 0.03 |
| Radiation: No/Unknown (ref) | |||||||||||
| Radiation | 709 | 0.08 (0.83) | 0.91 | 3497 | − 0.16 (0.36) | 0.64 | 1382 | 0.75 (0.57) | 0.18 | 0.77 | 0.55 |
| Missing | 576 | 3.19 (2.40) | 0.18 | 2160 | 0.33 (1.02) | 0.74 | 747 | 0.28 (1.63) | 0.86 | 0.45 | 0.08 |
CAHPS Consumer assessment of healthcare providers and systems, GED general education development, HS high school, int. interaction, NHA non-Hispanic Asian or Pacific Islander, NHB non-Hispanic Black or African American, NHW non-Hispanic white, ref referent, 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); other unspecified/unknown/multi-racial (194); education (1147)
Case-mix adjustments for years 1999–2019: Age at CAHPS survey (65–69, 70–74, 75–79, 80–84, ≥ 85); 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); Medicare plan type (other [prescription drug plan {PDP} or Medicare Advantage {MA}], fee-for-service Medicare); area-level poverty (0– < 20% poverty; 20–100% poverty; unknown/missing); race/ethnicity (NHW, NHB, NHA, Hispanic), extent of disease (localized; regional; distant), chemotherapy (no/unknown; chemotherapy; missing), radiation (no/unknown; radiation; missing)
Borderline cases for ER status (13) were excluded
Predictors and stratifications are mutually adjusted
Bold font indicates statistically significant with corresponding p < .05