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Current Realities of Delivering Mammography Services in the Community: Do Challenges with Staffing and Scheduling Exist?¹

¹ From the Breast Imaging Ctr, Dept of Radiology, Emory Univ, W.C.I. Building, 1701 Uppergate Dr, Suite C1104, Atlanta, GA 30322 (C.D.); Dept of Medicine, Univ of Washington, Seattle (S.P.T., C.N., J.G.E.); Dept of Community and Family Medicine, Dartmouth Medical School, Hanover and Lebanon, NH (P.A.C.); Ctr for Health Studies, Group Health Cooperative, Seattle, Wash (L.A.A., S.H.T., W.E.B.); Lynn Sage Comprehensive Breast Ctr, Dept of Radiology, Northwestern Univ Feinberg School of Medicine, Chicago, Ill (R.E.H., E.B.); Dept of Biostatistics, Univ of Alabama at Birmingham (G.R.C.); and Cancer Research and Biostatistics, Seattle, Wash (W.E.B.). Received Jan 23, 2004; revision requested Mar 31; revision received June 14; accepted July 21. Supported by Public Health Service grant HS-10591 (J.G.E.) from the Agency for Healthcare Research and Quality, and the National Cancer Institute, NIH, and the Department of Health and Human Services surveillance grants U01 CA 63731 (S.H.T.), 1 U01 CA86082–01 (P.A.C.), 5 U01 CA63736–09 (G.R.C.), and 5 U01 CA86076 (W.E.B.). Address correspondence to C.D. (e-mail: carl_dorsi@emoryhealthcare.org).

PURPOSE: To evaluate the current (2001–2002) capacity of community-based mammography facilities to deliver screening and diagnostic services in the United States.

MATERIALS AND METHODS: Institutional review board approvals and patient consent were obtained. A mailed survey was sent to 53 eligible mammography facilities in three states (Washington, New Hampshire, and Colorado). Survey questions assessed equipment and staffing availability, as well as appointment waiting times for screening and diagnostic mammography services. Criterion-related content and construct validity were obtained first by means of a national advisory committee of academic, scientific, and clinical colleagues in mammography that reviewed literature on existing surveys and second by pilot testing a series of draft surveys among community mammography facilities not inclusive of the study facilities. The final survey results were independently double entered into a relational database with programmed data checks. The data were sent encrypted by means of file transfer protocol to a central analytical center at Group Health Cooperative. A two-sided P value with = .05 was considered to show statistical significance in all analyses.

RESULTS: Forty-five of 53 eligible mammography facilities (85%) returned the survey. Shortages of radiologists relative to the mammographic volume were found in 44% of mammography facilities overall, with shortages of radiologists higher in not-for-profit versus for-profit facilities (60% vs 28% reported). Shortages of Mammography Quality Standards Act–qualified technologists were reported by 20% of facilities, with 46% reporting some level of difficulty in maintaining qualified technologists. Waiting times for diagnostic mammography ranged from less than 1 week to 4 weeks, with 85% performed within 1 week. Waiting times for screening mammography ranged from less than 1 week to 8 weeks, with 59% performed between 1 week and 4 weeks. Waiting times for both diagnostic and screening services were two to three times higher in high-volume compared with low-volume facilities.

CONCLUSION: Survey results show shortages of radiologists and certified mammography technologists.

© RSNA, 2005

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