Health System Factors

In conjunction with studies that collect self-report of patient perspectives and outcomes with cancer, CanSORT evaluates clinician and delivery system factors that shape the treatment experiences of patients with breast cancer. CanSORT is the first research team to identify clinicians, via cancer registries, for participation in health services research. CanSORT studies about health system factors have determined that it does matter which health systems and doctors individuals go to for cancer care. Within and between health systems and between physicians, there is often variability in knowledge of clinical guidelines, rates of use of common tests and treatments for cancer, and clinical opinions about net benefits of some treatments. Differences in provider influences have also been uncovered. Surgical oncologists have been determined to play a central role in decision-making about both surgical and non-surgical treatment for breast cancer.

The coordination of care among surgeons, medical oncologists, radiation oncologists, and primary care doctors has also been identified as important for patients and relates to their satisfaction with care. Although the majority of CanSORT health system factors research has focused on physicians, the role of nurses and allied health professionals, such as nurse navigators and genetic counselors, in cancer care is also being examined. The role nurses play in identifying and treating chemotherapy toxicities is a current focus of CanSORT research.