Location Isn't Everything: Proximity, Hospital Characteristics, Choice of Hospital, and Disparities for Breast Cancer Surgery Patients

Health Services Research
Nancy L KeatingAlan M Zaslavsky

Abstract

Assess the relative importance of proximity and other hospital characteristics in the choice of hospital for breast cancer surgery by race/ethnicity. SEER-Medicare data. Observational study of women aged >65 years receiving surgery for stage I/II/III breast cancer diagnosed in 1992-2007 in Detroit (N = 10,746 white/black), Atlanta (N = 4,018 white/black), Los Angeles (N = 9,433 white/black/Asian/Hispanic), and San Francisco (N = 4,856 white/black/Asian). We calculated the distance from each patient's census tract of residence to each area hospital. We estimated discrete choice models for the probability of receiving surgery at each hospital based on distance and assessed whether deviations from these predictions entailed interactions of hospital characteristics with the patient's race/ethnicity. We identified high-quality hospitals by rates of adjuvant radiation therapy and by survey measures of patient experiences, and we assessed how observed surgery rates at high-quality hospitals deviated from those predicted based on distance alone. Proximity was significantly associated with hospital choice in all areas. Minority more often than white breast cancer patients had surgery at hospitals with more minority patients, those treat...Continue Reading

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Citations

Jun 11, 2020·JCO Oncology Practice·Salma Shariff-MarcoAllison W Kurian
Apr 22, 2017·Female Pelvic Medicine & Reconstructive Surgery·Emily English, Lisa Rogo-Gupta
Nov 20, 2016·Health Services Research·Aaron L SchwartzJ Michael McWilliams
Feb 3, 2019·International Journal of Health Policy and Management·Suzanne Ruwaard, Rudy C M H Douven
Dec 10, 2020·The American Surgeon·Maria CastaldiRifat Latifi
Aug 16, 2018·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Shiyang ZhangGraham A Colditz
Jan 11, 2021·Annals of Surgical Oncology·Olga KantorTawakalitu Oseni
Mar 18, 2021·Journal of Cancer Education : the Official Journal of the American Association for Cancer Education·N D HernandezB M Rivers

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