What Do Hospitalists Think About Getting Inpatient Mammography for Hospitalized Women Who Are Overdue for Screening?

Background:

A recent study showed that many hospitalized women, particularly those who are low income and at high risk for developing breast cancer, are non‐adherent with breast cancer screening recommendations. This same study found that a majority of these women would be amenable to inpatient screening it were offered. This study explores hospitalists’ views about the appropriateness of inpatient breast cancer screening and their concerns about related matters.

2Methods:

A cross sectional study was conducted among four hospitalist groups affiliated with Johns Hopkins Medical Institute. Data was collected using an electronic survey program from May — October 2013. Chi square and t‐test statistics were used to identify hospitalist characteristics that support inpatient screening mammography.

Results:

The response rate was 92%. Fifty‐five percent of participating hospitalists were female, and respondents were diverse with respect to ethnicity (26% Asian, 15% African American, and 41% Caucasian). The informant hospitalists’ clinical experience in this field had a mean of 4.6 years, with 84% of them being full time. Only 38% believe that hospitalists should be involved in breast cancer screening. In response to clinical scenarios describing hospitalized women who are overdue for screening and at high risk for developing breast cancer, only 32% of hospitalists would order a screening mammogram. Lack of follow up on screening mammography results was cited the most common barrier, followed by concern that the cost would not be covered by insurance.

Conclusions:

Many hospitalists do not believe that they should be involved in breast cancer screening. In failing to offer mammography to high risk women who are overdue for screening, we are perpetuating disparity in health care among disadvantaged populations. Because the concerns about how best to follow up on test results and issues related to costs (including insurance coverage), we need to work out solutions that hospitalists are comfortable with. Future studies are needed to evaluate the feasibility and potential barriers to inpatient screening mammography.