Demographics predict patient preferences for breast imaging providers

Where women choose to go for breast imaging depends on whether they value expertise over convenience, or vice versa, as well as how much they care about care setting and how ambivalent they feel about the whole experience. Fortunately, their preferences largely track with demographic characteristics, making population-level priorities discoverable and actionable.

That’s according to a University of Texas MD Anderson Cancer Center study, the authors of which suggest breast-imaging providers fine-tune their operational strategies, as well as their marketing efforts, to make their care and outreach more patient-centered for each demographic they serve.

The American Journal of Roentgenology published the study online June 28.

Rajni Natesan, MD, MBA, and colleagues arrived at their conclusions after surveying all patients who went in for breast imaging at six sites (one inside an urban academic medical center and five affiliates at community-based breast imaging locations) in a large metropolitan area over a six-week period in 2015.

Responses came in from 1,682 patients (18 percent of total patient visits). The team organized the responses that met the study inclusion criteria (n = 876) into patient-preference clusters, which they tested for differences by location, reason for visit, age, education, marital status, ethnicity, insurance, history of cancer and income.

Analyzing the data, Natesan and colleagues identified four distinct cohorts into which the 876 patients fell: convenience optimizers (n = 109, 12.4 percent), ambivalent patients (n = 237, 27.1 percent), medical center seekers (n = 324, 37.0 percent) and expertise seekers (n = 206, 23.5 percent).

There were no significant differences in age, marital status, insurance, income and other demographic factors across these four cohorts, yet each cohort showed distinct preferences for imaging center location and radiologist training.

For example, “expertise seekers”—patients who showed a strong preference for radiologists with additional breast imaging training regardless of location—had the highest percentage of white respondents, while “convenience optimizers” had the highest percentage of African-American respondents.

Also, patients who preferred the academic medical setting reported a significantly greater personal history of cancer than did convenience optimizers and ambivalent patients. (The latter were so designated because they showed a greater degree of ambivalence about all preferences relative to the other cohorts.)

The authors acknowledge the uncertain generalizability of their findings among the limitations in their study design. “Given that metropolitan areas are noted to have 33 percent higher per capita income than nonmetropolitan areas, the findings in this study may be most applicable to other metropolitan areas across the country,” they write.

Natesan et al. express hope that their findings will help breast imaging providers establish and grow patient-centered breast imaging care practices.

“For example, healthcare organizations may want to choose a distributed location model to effectively serve the convenience optimizers cohort who prefer a relatively nearby community location over a more distant main urban medical center,” they write. “With sensitivity to the distinct needs and preferences of patient subpopulations, institutions can provide service and expand in meaningful ways to positively impact early detection of breast cancer and outcomes.”