Preoperative experience for public hospital patients with gynecologic cancer: Do structural barriers widen the gap?

BACKGROUND Widespread disparities in care have been documented in women with gynecologic cancer in the United States. This study was designed to determine whether structural barriers to optimal care were present during the preoperative period for patients with gynecologic cancer. METHODS A retrospec...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:Cancer Ročník 122; číslo 6; s. 859 - 867
Hlavní autoři: Frey, Melissa K., Moss, Haley A., Musa, Fernanda, Rolnitzky, Linda, David‐West, Gizelka, Chern, Jing‐Yi, Boyd, Leslie R., Curtin, John P.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 15.03.2016
Témata:
Adult
Aged
Female
Genital Neoplasms, Female - diagnosis
Genital Neoplasms, Female - surgery
gynecologic neoplasms
gynecologic surgery
health care disparities
health care inequalities
Healthcare Disparities
Hospitals, Private
Hospitals, Public
Humans
Insurance, Health
Length of Stay
Middle Aged
Neoplasm Staging
Preoperative Period
public hospitals
Retrospective Studies
Time-to-Treatment
gynecologic neoplasms
gynecologic surgery
health care disparities
public hospitals
health care inequalities
ISSN:0008-543X, 1097-0142, 1097-0142
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Popis
Shrnutí:BACKGROUND Widespread disparities in care have been documented in women with gynecologic cancer in the United States. This study was designed to determine whether structural barriers to optimal care were present during the preoperative period for patients with gynecologic cancer. METHODS A retrospective review was conducted for patients undergoing surgery for a gynecologic malignancy at a public hospital or a private hospital staffed by the same team of gynecologic oncologists between July 1, 2013 and July 1, 2014. RESULTS Two hundred fifty‐seven cases were included for analysis (public hospital, 69; private hospital, 188). Patients treated at the private hospital were older (58 vs 52 years; P = .004) and had similar medical comorbidities (median Charlson comorbidity index at both hospitals, 6) but required fewer hospital visits in preparation for surgery (2 vs 4; P < .001). Public hospital patients had a longer wait time from the diagnosis of disease to surgery (63 vs 34 days; P < .001). According to a multiple linear regression model, the public hospital setting was associated with a longer interval from diagnosis to surgery with adjustments for the insurance status, age at diagnosis, cancer stage, and number of preoperative hospital visits (P < .001). CONCLUSIONS Patients at the public hospital were subject to a greater number of preoperative visits and had to wait longer for surgery than patients at the private hospital. Attempts to reduce health care disparities should focus on improving efficiency in health care delivery systems once contact has been established. Cancer 2016;122:859–67. © 2016 American Cancer Society. Health care disparities are present during the preoperative window for women with gynecologic cancer. Patients at a public hospital are subject to a greater number of preoperative visits and have to wait longer for surgery than patients at a private hospital.
Bibliografie:This study was presented as an oral presentation at the Society of Gynecologic Oncology Early Education Summit in December 2014 and was presented as a poster at the Society of Gynecologic Oncology Annual Meeting in March 2015.
We acknowledge Claudia Plottel, MD (New York University Langone Medical Center, Clinical and Translational Science Institute, New York University School of Medicine) for her support and participation in this project.
ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:0008-543X
1097-0142
1097-0142
DOI:10.1002/cncr.29859