TY  - JOUR
AU  - Kranz, Ashley M.
AU  - Ryan, Jamie
AU  - Mahmud, Ammarah
AU  - Setodji, Claude Messan
AU  - Damberg, Cheryl L.
AU  - Timbie, Justin W.
PY  - 2020
TI  - Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics
T2  - Preventing Chronic Disease
JO  - Prev Chronic Dis
SP  - E134
VL  - 17
CY  - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
N2  - INTRODUCTION  Primary care providers who lack reliable referral relationships with specialists may be less likely than those who do have such relationships to conduct cancer screenings. Community health centers (CHCs), which provide primary care to disadvantaged populations, have historically reported difficulty accessing specialty care for their patients. This study aimed to describe strategies CHCs use to integrate care with specialists and examine whether more strongly integrated CHCs have higher rates of screening for colorectal and cervical cancers and report better communication with specialists. METHODS  Using a 2017 survey of CHCs in 12 states and the District of Columbia and administrative data, we estimated the association between a composite measure of CHC/specialist integration and 1) colorectal and cervical cancer screening rates, and 2) 4 measures of CHC/specialist communication using multivariate regression models. RESULTS  Integration strategies commonly reported by CHCs included having specialists deliver care on-site (80%) and establishing referral agreements with specialists (70%). CHCs that were most integrated with specialists had 5.6 and 6.8 percentage-point higher colorectal and cervical cancer screening rates, respectively, than the least integrated CHCs (P < .05). They also had significantly higher rates of knowing that specialist visits happened (67% vs 42%), knowing visit outcomes (65% vs 42%), receiving information after visits (47% vs 21%), and timely receipt of information (44% vs 27%). CONCLUSION  CHCs use various strategies to integrate primary and specialty care. Efforts to promote CHC/specialist integration may help increase rates of cancer screening.
SN  - 1545-1151
UR  - https://doi.org/10.5888/pcd17.200025
DO  - 10.5888/pcd17.200025
ER  - 
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