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. 2013 Oct;48(5):1669-83.
doi: 10.1111/1475-6773.12063. Epub 2013 May 13.

Racial/Ethnic differences in receipt of timely adjuvant therapy for older women with breast cancer: are delays influenced by the hospitals where patients obtain surgical care?

Rachel A Freedman  1 , Yulei He, Eric P Winer, Nancy L Keating
Affiliations

Racial/Ethnic differences in receipt of timely adjuvant therapy for older women with breast cancer: are delays influenced by the hospitals where patients obtain surgical care?

Rachel A Freedman et al. Health Serv Res. 2013 Oct.

Abstract

Objective: To examine whether hospitals where patients obtain care explain racial/ethnic differences in treatment delay.

Data source: Surveillance, Epidemiology, and End Results data linked with Medicare claims.

Study design: We examined delays in adjuvant chemotherapy or radiation for women diagnosed with stage I-III breast cancer during 1992-2007. We used multivariable logistic regression to assess the probability of delay by race/ethnicity and included hospital fixed effects to assess whether hospitals explained disparities.

Principal findings: Among 54,592 women, black (11.9 percent) and Hispanic (9.9 percent) women had more delays than whites (7.8 percent, p < .0001). After adjustment, black (vs. white) women had higher odds of delay (odds ratio = 1.25, 95 percent confidence interval = 1.10-1.42), attenuated somewhat by including hospital fixed effects (OR = 1.17, 95 percent CI = 1.02-1.33).

Conclusions: Hospitals are the important contributors to racial disparities in treatment delay.

Keywords: Breast cancer; delays; disparities.

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Figures

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Figure 1
Study Inclusions and Exclusions
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References

    1. Barnato AE, Lucas FL, Staiger D, Wennberg DE, Chandra A. “Hospital-Level Racial Disparities in Acute Myocardial Infarction Treatment and Outcomes”. Medical Care. 2005;43(4):308–19. - PMC - PubMed
    1. Bickell NA, Wang JJ, Oluwole S, Schrag D, Godfrey H, Hiotis K, Mendez J, Guth AA. “Missed Opportunities: Racial Disparities in Adjuvant Breast Cancer Treatment”. Journal of Clinical Oncology. 2006;24(9):1357–62. - PubMed
    1. Bickell NA, Weidmann J, Fei K, Lin JJ, Leventhal H. “Underuse of Breast Cancer Adjuvant Treatment: Patient Knowledge, Beliefs, and Medical Mistrust”. Journal of Clinical Oncology. 2009;27(31):5160–7. - PMC - PubMed
    1. Breslin TM, Morris AM, Gu N, Wong SL, Finlayson EV, Banerjee M, Birkmeyer JD. “Hospital Factors and Racial Disparities in Mortality after Surgery for Breast and Colon Cancer”. Journal of Clinical Oncology. 2009;27(24):3945–50. - PMC - PubMed
    1. Buist DS, Chubak J, Prout M, Yood MU, Bosco JL, Thwin SS, Gold HT, Owusu C, Field TS, Quinn VP, Wei F, Silliman RA. “Referral, Receipt, and Completion of Chemotherapy in Patients with Early-Stage Breast Cancer Older Than 65 Years and at High Risk of Breast Cancer Recurrence”. Journal of Clinical Oncology. 2009;27(27):4508–14. - PMC - PubMed

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