PMID- 29450752
OWN - NLM
STAT- MEDLINE
DCOM- 20190215
LR  - 20190215
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 25
IP  - 5
DP  - 2018 May
TI  - Racial and Socioeconomic Differences in the Use of High-Volume Commission on
      Cancer-Accredited Hospitals for Cancer Surgery in the United States.
PG  - 1116-1125
LID - 10.1245/s10434-018-6374-0 [doi]
AB  - BACKGROUND: Although major cancer surgery at a high-volume hospital is associated
      with lower postoperative mortality, the use of such hospitals may not be equally 
      distributed. OBJECTIVE: Our aim was to study socioeconomic and racial differences
      in cancer surgery at Commission on Cancer (CoC)-accredited high-volume hospitals.
      METHODS: The National Cancer Database (NCDB) was used to identify patients
      undergoing surgery for colon, esophageal, liver, and pancreatic cancer from 2003 
      to 2012. Annual hospital volume for each cancer was categorized using quartiles
      of patient volume. Patient-level predictors of surgery at a high-volume hospital,
      trends in the use of a high-volume hospital, and adjusted likelihood of surgery
      at a high-volume hospital in 2012 versus 2003 were analyzed. RESULTS: African
      American patients were less likely to undergo surgery at a high-volume hospital
      for esophageal (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.49-0.73) and
      pancreatic cancer (OR 0.83, 95% CI 0.74-0.92), while uninsured patients and those
      residing in low educational attainment zip codes were less likely to undergo
      surgery at a high-volume hospital for esophageal, liver, and pancreatic cancer.
      In 2012, African Americans, uninsured patients, and those from low educational
      attainment zip codes were no more likely to undergo surgery at a high-volume
      hospital than in 2003 for any cancer type. These differences were not seen in
      colon cancer patients, for whom significant regionalization was not seen.
      CONCLUSIONS: Differences in the use of CoC-accredited high-volume hospitals for
      major cancer surgery were seen nationwide and persisted over the duration of the 
      study. Strategies to increase referrals and/or access to high-volume hospitals
      for African American and socioeconomically disadvantaged patients should be
      explored.
FAU - Wasif, Nabil
AU  - Wasif N
AD  - Department of Surgery, Division of Surgical Oncology, Mayo Clinic Arizona,
      Phoenix, AZ, USA. wasif.nabil@mayo.edu.
AD  - Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery,
      Surgical Outcomes Program, Mayo Clinic Arizona, Phoenix, AZ, USA.
      wasif.nabil@mayo.edu.
FAU - Etzioni, David
AU  - Etzioni D
AD  - Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery,
      Surgical Outcomes Program, Mayo Clinic Arizona, Phoenix, AZ, USA.
AD  - Department of Surgery, Division of Colorectal Surgery, Mayo Clinic Arizona,
      Phoenix, AZ, USA.
FAU - Habermann, Elizabeth B
AU  - Habermann EB
AD  - Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery,
      Surgical Outcomes Program, Mayo Clinic Arizona, Phoenix, AZ, USA.
FAU - Mathur, Amit
AU  - Mathur A
AD  - Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery,
      Surgical Outcomes Program, Mayo Clinic Arizona, Phoenix, AZ, USA.
AD  - Department of Surgery, Division of Transplant Surgery, Mayo Clinic Arizona,
      Phoenix, AZ, USA.
FAU - Pockaj, Barbara A
AU  - Pockaj BA
AD  - Department of Surgery, Division of Surgical Oncology, Mayo Clinic Arizona,
      Phoenix, AZ, USA.
FAU - Gray, Richard J
AU  - Gray RJ
AD  - Department of Surgery, Division of Surgical Oncology, Mayo Clinic Arizona,
      Phoenix, AZ, USA.
FAU - Chang, Yu-Hui
AU  - Chang YH
AD  - Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery,
      Surgical Outcomes Program, Mayo Clinic Arizona, Phoenix, AZ, USA.
AD  - Department of Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, USA.
LA  - eng
PT  - Journal Article
DEP - 20180215
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
SB  - IM
MH  - Accreditation
MH  - African Americans/*statistics & numerical data
MH  - Aged
MH  - Aged, 80 and over
MH  - Colonic Neoplasms/surgery
MH  - Databases, Factual
MH  - Educational Status
MH  - Esophageal Neoplasms/surgery
MH  - European Continental Ancestry Group/statistics & numerical data
MH  - Female
MH  - Health Services Accessibility
MH  - Hospitals, High-Volume/*statistics & numerical data/trends
MH  - Humans
MH  - Income
MH  - Liver Neoplasms/surgery
MH  - Male
MH  - Medically Uninsured/*statistics & numerical data
MH  - Middle Aged
MH  - Neoplasms/*surgery
MH  - Pancreatic Neoplasms/surgery
MH  - Rural Population/statistics & numerical data
MH  - United States
MH  - Urban Population/statistics & numerical data
EDAT- 2018/02/17 06:00
MHDA- 2019/02/16 06:00
CRDT- 2018/02/17 06:00
PHST- 2017/08/29 00:00 [received]
PHST- 2018/02/17 06:00 [pubmed]
PHST- 2019/02/16 06:00 [medline]
PHST- 2018/02/17 06:00 [entrez]
AID - 10.1245/s10434-018-6374-0 [doi]
AID - 10.1245/s10434-018-6374-0 [pii]
PST - ppublish
SO  - Ann Surg Oncol. 2018 May;25(5):1116-1125. doi: 10.1245/s10434-018-6374-0. Epub
      2018 Feb 15.