Journal article
Ethnic/Racial Disparities in Hospital Procedure Volume for Lung Resection for Lung Cancer
Medical care, v 45(7), pp 655-663
01 Jul 2007
PMID: 17571014
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Ethnic/racial minorities experience poorer outcomes from lung cancer than non-Hispanic whites. Higher hospital procedure volume is associated with better survival from lung resection for lung cancer. Objectives: We examined whether (1) ethnic/racial minorities are more likely to obtain lung resections at lower volume hospitals, (2) ethnicity/race is associated with inpatient mortality, (3) hospital volume mediates this association, and (4) hospital selection is mediated by racial/ethnic segregation, differences in insurance coverage, or limited hospital choice. Methods: Six years of data from the Nationwide Inpatient Sample (NIS 1998-2003, unweighted n = 50,245, weighted n = 129,506) were used in multivariate models controlling for sociodemographic factors, case complexity, and hospital characteristics. Additional analyses were conducted using the Area Resource File, which provided data on ethnic density and number of surgical hospitals in the hospital region. Results: Blacks/African Americans (odds ratio [OR] = 0.45; 0.34-0.58) and Latinos ( OR = 0.44; 0.32-0.63) had lower odds of obtaining lung resection at a high-volume hospital than non- Hispanic whites. Blacks/African Americans (OR = 1.30; 1.01-1.67), Latinos (OR = 1.41; 1.02- 1.94), and other racial/ethnic minorities (OR = 1.46; 1.04-2.06) also had higher odds of dying in hospital, but this association was statistically nonsignificant after controlling for hospital volume. Hospital location was not associated with lung resection procedure volume, nor did location mediate the association between ethnicity/race and hospital volume. Conclusions: Ethnic/racial minorities are obtaining lung resection in lower volume hospitals and are more likely to die in hospital. Hospital volume is associated with higher mortality, but health insurance, segregation, and number of surgical hospitals within a county do not account for observed disparities.
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Details
- Title
- Ethnic/Racial Disparities in Hospital Procedure Volume for Lung Resection for Lung Cancer
- Creators
- Charles J. Neighbors - National Center on Addiction and Substance Abuse at Columbia UniversityMichelle L. Rogers - John Brown UniversityEdmond D. Shenassa - John Brown UniversityChristopher N. SciamannaMelissa A. Clark - John Brown UniversityScott P. Novak - RTI International
- Publication Details
- Medical care, v 45(7), pp 655-663
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science
- Web of Science ID
- WOS:000247788500010
- Scopus ID
- 2-s2.0-34250691673
- Other Identifier
- 991021786471604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Health Care Sciences & Services
- Health Policy & Services
- Public, Environmental & Occupational Health