Can case management be used to facilitate diagnostic testing in publicly funded breast cancer screening programs?

The earlier breast cancer can be diagnosed and treated, the better the odds for survival. The literature has shown many of the barriers to timely diagnosis are not individual behaviors but problems in delivery of health care. Case management has been suggested to facilitate diagnostic testing and treatment. Models of case management exist in other practice settings but have not always been rigorously described or evaluated. Determining optimal models for case management has been established federally as a research priority to ensure medically underserved women are promptly diagnosed and treated. One model has been developed and pilot-tested in this setting. This article will describe elements of case management and the characteristics of a publicly funded screening program that make use of case management to facilitate timeliness of diagnostic testing different from case management in other settings. These differences have implications for successfully implementing case management in public programs.