Evidence for racial/ethnic disparities in emergency department visits following breast cancer surgery among women in California: a population‑based study

Details

• Alternative Title:
  Breast Cancer Res Treat
• Personal Author:
  Falcone, Mary ; Liu, Lihua ; Farias, Albert ; Zhang, JuanJuan ; Kang, Irene ; Li, Ming ; Stern, Mariana C. ; Lerman, Caryn
• Description:
  Purpose
  
  Racial/ethnic disparities in breast cancer outcomes may be related to quality of care and reflected in emergency department (ED) visits following primary treatment. We examined racial/ethnic variation in ED visits following breast cancer surgery.
  
  Methods
  
  Using linked data from the California Cancer Registry and California Office of Statewide Health Planning and Development, we identified 151,229 women diagnosed with stage 0-III breast cancer between 2005 and 2013 who received surgical treatment. Differences in odds of having at least one breast cancer-related ED visit within 90 days post-surgery were estimated with logistic regression controlling for clinical and sociodemographic variables. Secondary analyses examined health care-related moderators of disparities.
  
  Results
  
  Hispanics and non-Hispanic (NH) Blacks had an increased likelihood of having an ED visit within 90 days of surgery compared to NH Whites [OR = 1.11 (1.04–1.18), p = 0.0016; OR = 1.38 (1.27–1.50), p < 0.0001, respectively]; the likelihood was reduced in Asian/Pacific Islanders [aOR = 0.77 (0.71–0.84), p < 0.0001]. Medicaid and Medicare (vs. commercial insurance) increased the likelihood of ED visit for NH Whites, and to a lesser degree for Hispanics and NH Blacks (p < 0.0001 for interaction). Receipt of surgery at an NCI-designated Comprehensive Cancer Center or at a for-profit (vs. non-profit) hospital was associated with reduced likelihood of ED visits for all groups.
  
  Conclusion
  
  Racial/ethnic disparities in ED visits following breast cancer surgery persist after controlling for clinical and sociodemographic variables. Improving quality of care following breast cancer surgery could improve outcomes for all groups.
  
  
• Subjects:
  Aged Breast Neoplasms California Emergency Service, Hospital Ethnicity Female Healthcare Disparities Hispanic Or Latino Humans Medicare United States

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• Keywords:
  Breast Cancer Emergency Department Visits Health Disparities
• Source:
  Breast Cancer Res Treat. 187(3):831-841
• Pubmed ID:
  33675489
• Pubmed Central ID:
  PMC10373425
• Document Type:
  Journal Article
• Funding:
  HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; P30 CA014089/CA/NCI NIH HHSUnited States/ ; R35 CA197461/CA/NCI NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; R35 CA197461/NH/NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/
• Volume:
  187
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:7620c9bf8ad8502d5d2a21bdc69c9dc6690e50c5a7958bca2602631cd63df9f15f066500e2ffbbaf6743fb0edb09de88121b2535e1778f9fc8d6f26fdbe0e743
• Download URL:
  https://stacks.cdc.gov/view/cdc/131475/cdc_131475_DS1.pdf
• File Type:
  [PDF - 792.05 KB ]