The role of patient primary language in access to brain tumor resection: Evaluating emergent admission and hospital volume.

Autor: Witt EE; Harvard Medical School, 260 Longwood Ave, Boston, MA, 02115, United States; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St Suite 2-016, Boston, MA, 02120, United States. Electronic address: emily_witt@hms.harvard.edu., Eruchalu CN; Harvard Medical School, 260 Longwood Ave, Boston, MA, 02115, United States; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St Suite 2-016, Boston, MA, 02120, United States., Dey T; Harvard Medical School, 260 Longwood Ave, Boston, MA, 02115, United States; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St Suite 2-016, Boston, MA, 02120, United States., Bates DW; Harvard Medical School, 260 Longwood Ave, Boston, MA, 02115, United States; Division of General and Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St Suite BC3-002, Boston, MA, 02120, United States., Goodwin CR; Department of Neurosurgery, Duke University Medical Center, 10 Duke Medicine Cir, Durham, NC, 27710, United States; Duke Center for Brain and Spinal Metastases, Duke University Medical Center, 20 Duke Medicine Cir, Durham, NC, 27710, United States., Ortega G; Harvard Medical School, 260 Longwood Ave, Boston, MA, 02115, United States; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St Suite 2-016, Boston, MA, 02120, United States.
Jazyk: angličtina
Zdroj: Journal of cancer policy [J Cancer Policy] 2021 Dec; Vol. 30, pp. 100306. Date of Electronic Publication: 2021 Sep 20.
DOI: 10.1016/j.jcpo.2021.100306
Abstrakt: Background: This study investigated the effect of limited English proficiency on access to neuro-oncologic surgery. We compared rates of emergent/urgent admission and admission to high-volume hospitals for English and non-English primary language patients with brain neoplasms.
Methods: Using the AHRQ-HCUP New Jersey State Inpatient Database, we included patients 18-90 years old who underwent resection of a supratentorial primary brain tumor (PBT), meningioma (MA) or brain metastasis (BM) from 2009-2017. Outcomes were emergent/urgent admission and annual hospital procedure volume. Univariable and multivariable analyses compared Spanish (SPL), Non-English Non-Spanish (NENS), and English (EPL) primary language groups.
Results: 7,402 patients were included: 2,996 PBT, 2,115 MA, and 2,291 BM. SPL patients (n = 300) were younger and had a greater proportion of non-commercially insured, low-income patients with lower comorbidity scores. NENS patients (n = 260) had similar age and comorbidity scores as EPL patients, but a greater proportion had non-commercial insurance and low income (p < 0.001). Multivariable analysis revealed NENS, but not SPL, patients had increased odds of emergent/urgent admission (2.10(1.50-2.93), p < 0.001), but demonstrated no association between admission to higher volume centers and primary language.
Conclusion: Patient primary language may influence access to timely neurosurgical care, but access to high-volume centers appears to be mediated by other factors.
Policy Summary Statement: In addition to efforts to improve health care access for patients with limited English proficiency, multilingual health literacy and patient education interventions may help to promote timely presentation for brain tumor resection among this vulnerable patient population.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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