Grant Number:	5R01CA081338-02 Interpret this number
Primary Investigator:	Kahn, Katherine
Organization:	Rand Corporation
Project Title:	Processes and Outcomes of Breast Cancer Care
Fiscal Year:	2001

The continuing rapid evolution of U.S. health care delivery has raised expectations that the medical marketplace will compete on how care is delivered (i.e., processes of care) and how patients fare (i.e., outcomes of care), in addition to how much care will cost. We propose to evaluate the building blocks of a feasible, reliable, and valid population-based measurement system for elderly breast cancer patients so that scientifically based knowledge will be available to those undertaking comparative studies of care and outcomes for cancer patients during the next decade. Using patient self-report data at diagnosis and one year after diagnosis and medical record data as supplements to registry data, we will describe how variations in patient characteristics at the time of diagnosis, processes, and outcomes of care can vary as a function of the definition of performance measures, the data source used to assess performance, and the definition of the study cohort. The project s specific aims are. 1. To identify a complete cohort of population-based, newly diagnosed older breast cancer patients using existing Rapid Case Ascertainment (RCA) strategies of the Cancer Surveillance Program in Los Angeles County. 2. To use available patient self-report and medical record data as supplements to registry data, to describe variations in patient characteristics at the time of diagnosis, measures of process of care, and patient outcomes. 3. To assess the degree to which process scores can be explained by baseline patient characteristics such as burden of illness at diagnosis, demographics, and system of care. 4. To assess the degree to which outcomes can be explained by processes of care after accounting for baseline patient characteristics such as burden of illness at diagnosis, demographics, and system of care. 5. To assess the degree to which the reliability and validity of measures of baseline patient characteristics, processes of care, and outcomes vary as a function of data sources for those elements. 6. To assess the degree to which the reliability and validity of measures of baseline patient characteristics, processes of care, and outcomes can be influenced by selection biases. 7. To assess ways in which important comparisons between policy relevant groups such as patients treated with fee-for- service vs. managed care, younger vs. older age cohorts, or more vs. less affluent socioeconomic groups vary as a function of: definition of the measures of baseline patient characteristics, processes, and outcomes; data source; and definition of the cohort.




Prevalence, predictors, and patient outcomes associated with physician co-management: findings from the Los Angeles Women's Health Study.
Authors: Rose D.E. , Tisnado D.M. , Tao M.L. , Malin J.L. , Adams J.L. , Ganz P.A. , Kahn K.L. .
Source: Health Services Research, 2012 Jun; 47(3 Pt 1), p. 1091-116.
PMID: 22171977
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Use of interpreters by physicians treating limited English proficient women with breast cancer: results from the provider survey of the Los Angeles Women's Health Study.
Authors: Rose D.E. , Tisnado D.M. , Malin J.L. , Tao M.L. , Maggard M.A. , Adams J. , Ganz P.A. , Kahn K.L. .
Source: Health Services Research, 2010 Feb; 45(1), p. 172-94.
PMID: 19878346
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Variation in physician-patient discussion of breast reconstruction.
Authors: Chen J.Y. , Malin J. , Ganz P.A. , Ko C. , Tisnado D. , Tao M.L. , Timmer M. , Adams J.L. , Kahn K.L. .
Source: Journal Of General Internal Medicine, 2009 Jan; 24(1), p. 99-104.
PMID: 19023629
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Impact of physician-patient discussions on patient satisfaction.
Authors: Chen J.Y. , Tao M.L. , Tisnado D. , Malin J. , Ko C. , Timmer M. , Adams J.L. , Ganz P.A. , Kahn K.L. .
Source: Medical Care, 2008 Nov; 46(11), p. 1157-62.
PMID: 18953226
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On referral patterns for patients with breast cancer.
Authors: Kahn K.L. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2007-01-20 00:00:00.0; 25(3), p. 244-6.
PMID: 17235041
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The case identification challenge in measuring quality of cancer care.
Authors: Pearson M.L. , Ganz P.A. , McGuigan K. , Malin J.R. , Adams J. , Kahn K.L. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2002-11-01 00:00:00.0; 20(21), p. 4353-60.
PMID: 12409335
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Developing a reliable, valid, and feasible plan for quality-of-care measurement for cancer: how should we measure?
Authors: Kahn K.L. , Malin J.L. , Adams J. , Ganz P.A. .
Source: Medical Care, 2002 Jun; 40(6 Suppl), p. III73-85.
PMID: 12064761
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