Breast cancer screening practices of safety net clinics: Results of a needs assessment study

BACKGROUND: For low income and uninsured populations, safety net clinics are an important source of health care, including preventive services such as mammography screening. However, little is known about how well breast health is coordinated within the safety net clinic environment and what barriers patients encounter. METHODS: A needs assessment was conducted among eight community-based safety net clinics located in Montgomery County, Maryland to learn about breast cancer referral and screening procedures. Structured in-depth interviews were conducted with clinic staff during the summer of 2008. RESULTS: Safety net clinics reported that they routinely identified women who need mammography screening and referred women to mammography screening facilities. However, clinics were not aware of the limited number of free or low cost mammography screening slots available in the county or the waiting time to receive mammography services. Overall, screening barriers were common in the safety net system and only a few procedures were in place to help women overcome these barriers. CONCLUSION: Safety net clinics face multiple barriers in providing and coordinating breast cancer screening services for low income or uninsured patients. These barriers prevent the efficient allocation of mammography screening services and prevent underserved women from accessing an important preventive health service.