Dawood H Sultan1, Jemal Gishe2, Angella Hanciles3, Meg M Comins4, Claire M Norris5. 1. Department of Health Policy and Management, College of Public Health, University of South Florida, 13201 Bruce B. Downs BLVD, MDC 56, Tampa, FL, 33612-3805, USA. dsultan@health.usf.edu. 2. Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs BLVD, MDC 56, Tampa, FL, 33612-3805, USA. jgishe@health.usf.edu. 3. Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs BLVD, MDC 56, Tampa, FL, 33612-3805, USA. ahancile@health.usf.edu. 4. Department of Health Policy and Management, College of Public Health, University of South Florida, 13201 Bruce B. Downs BLVD, MDC 56, Tampa, FL, 33612-3805, USA. comins.meg@gmail.com. 5. Louisiana Board of Regents, 1201 N. Third St., Suite 6-200, Baton Rouge, LA, 70802, USA. clairexula@gmail.com.
Abstract
PURPOSE: To examine cancer treatment disparities at a National Cancer Institute-designated comprehensive cancer center (NCI-CCC) and non-specialty hospitals. MATERIALS AND METHODS: Florida hospital discharge datasets were used. ICD9-CM codes were used to define patients with female reproductive organ cancers (FROC), male reproductive organ cancers (MROC), and OTHER cancer diagnoses. A total of 7462 NCI-CCC patients and 21,875 non-specialty hospital patients were included in the statistical analysis. Data analysis was conducted in SAS 9.2. RESULTS: Increases in age reduced the odds of receiving treatment at the NCI-CCC. Male patients were more likely than female patients to be treated at the NCI-CCC. Age-adjusted odds of African American and Hispanic out/inpatients being treated at the NCI-CCC were significantly lower than those of White out/inpatients. Only patients with workers' compensation, charity, or other insurance had higher odds of being treated at the NCI-CCC. The odds of minority patients receiving outpatient treatment at the NCI-CCC declined after 2005. The odds of receiving inpatient treatment at the NCI-CCC significantly increased after 2006. CONCLUSIONS: More targeted outreach by the NCI-CCC is required. However, we expect the creation of local Accountable Care Organizations (ACOs) to reduce the numbers of minority and older patients at the NCI-CCC. Coordinated quality care at ACOs implies a potential for retaining the patient market share held by non-specialty hospitals and a potential for increased demand for ACO care by minority and older patients.
PURPOSE: To examine cancer treatment disparities at a National Cancer Institute-designated comprehensive cancer center (NCI-CCC) and non-specialty hospitals. MATERIALS AND METHODS: Florida hospital discharge datasets were used. ICD9-CM codes were used to define patients with female reproductive organ cancers (FROC), male reproductive organ cancers (MROC), and OTHER cancer diagnoses. A total of 7462 NCI-CCC patients and 21,875 non-specialty hospital patients were included in the statistical analysis. Data analysis was conducted in SAS 9.2. RESULTS: Increases in age reduced the odds of receiving treatment at the NCI-CCC. Male patients were more likely than female patients to be treated at the NCI-CCC. Age-adjusted odds of African American and Hispanic out/inpatients being treated at the NCI-CCC were significantly lower than those of White out/inpatients. Only patients with workers' compensation, charity, or other insurance had higher odds of being treated at the NCI-CCC. The odds of minority patients receiving outpatient treatment at the NCI-CCC declined after 2005. The odds of receiving inpatient treatment at the NCI-CCC significantly increased after 2006. CONCLUSIONS: More targeted outreach by the NCI-CCC is required. However, we expect the creation of local Accountable Care Organizations (ACOs) to reduce the numbers of minority and older patients at the NCI-CCC. Coordinated quality care at ACOs implies a potential for retaining the patient market share held by non-specialty hospitals and a potential for increased demand for ACO care by minority and older patients.
Entities:
Keywords:
African American; Comprehensive Cancer Center; Hispanic; Minority
Authors: Ian K Komenaka; Maria Elena Martinez; Robert E Pennington; Chiu-Hsieh Hsu; Susan E Clare; Patricia A Thompson; Colleen Murphy; Noelia M Zork; Robert J Goulet Journal: J Natl Cancer Inst Date: 2010-06-23 Impact factor: 13.506
Authors: Sara E Grineski; Danielle X Morales; Timothy Collins; Jacob Wilkes; Joshua L Bonkowsky Journal: J Racial Ethn Health Disparities Date: 2020-02-24