OBJECTIVE: To examine inpatient utilization of pediatric cancer specialty centers (PCSCs) by pediatric oncology patients. STUDY DESIGN: We performed a retrospective (1999 to 2010) population-based analysis of oncology hospitalizations for pediatric patients aged 0 through 18 years using the California Office of Statewide Health Planning and Development database. Logistic regression examined hospitalization at 29 PCSCs and variables of age, sex, tumor type, payer, race, income, and distance to admission site. RESULTS: Analysis of 103,961 pediatric oncology discharges revealed that 93% occurred at PCSCs. These sites experienced a 20% increase in pediatric oncology discharges, conversely non-PCSCs exhibited a 70% decrease (P<0.0001). Multivariate analyses revealed increased utilization with young age (odds ratio [OR], 4.58; 95% CI, 3.88-5.42), African American (OR, 1.26; 95% CI, 1.11-1.43), and middle income (OR, 1.36; 95% CI, 1.29-1.45). Decreased utilization was seen for females (OR, 0.88; 95% CI, 0.84-0.93) and Hispanics (OR, 0.72; 95% CI, 0.68-0.77). Payer and proximity were not significantly associated with change in utilization. Tumor types less likely to utilize a PCSC included germ cell, solid, and central nervous system tumors. Adolescents were >3 times less likely to be treated at a PCSC. CONCLUSIONS: Inpatient pediatric oncology care in California has become increasingly regionalized with the vast majority of patients accessing PCSCs. However, variability in hospitalizations of adolescent patients and children not treated in PCSCs deserve further evaluation.
OBJECTIVE: To examine inpatient utilization of pediatric cancer specialty centers (PCSCs) by pediatric oncology patients. STUDY DESIGN: We performed a retrospective (1999 to 2010) population-based analysis of oncology hospitalizations for pediatric patients aged 0 through 18 years using the California Office of Statewide Health Planning and Development database. Logistic regression examined hospitalization at 29 PCSCs and variables of age, sex, tumor type, payer, race, income, and distance to admission site. RESULTS: Analysis of 103,961 pediatric oncology discharges revealed that 93% occurred at PCSCs. These sites experienced a 20% increase in pediatric oncology discharges, conversely non-PCSCs exhibited a 70% decrease (P<0.0001). Multivariate analyses revealed increased utilization with young age (odds ratio [OR], 4.58; 95% CI, 3.88-5.42), African American (OR, 1.26; 95% CI, 1.11-1.43), and middle income (OR, 1.36; 95% CI, 1.29-1.45). Decreased utilization was seen for females (OR, 0.88; 95% CI, 0.84-0.93) and Hispanics (OR, 0.72; 95% CI, 0.68-0.77). Payer and proximity were not significantly associated with change in utilization. Tumor types less likely to utilize a PCSC included germ cell, solid, and central nervous system tumors. Adolescents were >3 times less likely to be treated at a PCSC. CONCLUSIONS: Inpatient pediatric oncology care in California has become increasingly regionalized with the vast majority of patients accessing PCSCs. However, variability in hospitalizations of adolescent patients and children not treated in PCSCs deserve further evaluation.
Authors: Deirdre A Caplin; Ken R Smith; Kirsten K Ness; Heidi A Hanson; Stephanie M Smith; Paul C Nathan; Melissa M Hudson; Wendy M Leisenring; Leslie L Robison; Kevin C Oeffinger Journal: J Adolesc Young Adult Oncol Date: 2016-10-18 Impact factor: 2.223
Authors: Arash Anoshiravani; Olga Saynina; Lisa Chamberlain; Benjamin A Goldstein; Lynne C Huffman; N Ewen Wang; Paul H Wise Journal: J Adolesc Health Date: 2015-07-21 Impact factor: 5.012
Authors: Emily E Johnston; Elysia Alvarez; Olga Saynina; Lee M Sanders; Smita Bhatia; Lisa J Chamberlain Journal: Cancer Date: 2018-02-02 Impact factor: 6.860
Authors: Emily E Johnston; Lori Muffly; Elysia Alvarez; Olga Saynina; Lee M Sanders; Smita Bhatia; Lisa J Chamberlain Journal: J Clin Oncol Date: 2018-09-05 Impact factor: 44.544