Disparities in utilization of services for racial and ethnic minorities with hepatocellular carcinoma associated with hepatitis C
| Autor: | Alissa Greenbaum, Su Wang, H. Richard Alexander, Patrick Hilden, Miral S. Grandhi, David August, Timothy J. Kennedy, Joanna Sesti, Aaron Kangas-Dick, Russell C. Langan, Darren R. Carpizo, Stuart Geffner, Victor Gall, Subroto Paul, Amber L. Turner |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Carcinoma Hepatocellular Databases Factual medicine.medical_treatment Population 030230 surgery Liver transplantation 03 medical and health sciences 0302 clinical medicine medicine Humans Healthcare Disparities education Socioeconomic status Hepatitis education.field_of_study business.industry Incidence (epidemiology) Liver Neoplasms Hepatitis C Middle Aged medicine.disease Comorbidity United States 030220 oncology & carcinogenesis Hepatocellular carcinoma Surgery Female business Demography |
| Zdroj: | Surgery. 168(1) |
| ISSN: | 1532-7361 |
| Popis: | Background Hepatitis C affects racial minorities disproportionately and is greatest among the black population. The incidence of hepatocellular carcinoma has increased with the largest increase observed in black and Hispanic populations, but limited data remain on whether hepatitis C hepatocellular carcinoma in racial-ethnic minorities have the same utilization of services compared with the white population. Methods We used the database of the National Inpatient Sample to identify hepatitis C-hepatocellular carcinoma patients (N = 200,163) who underwent liver transplantation (n = 11,491), liver resection (n = 4,896), or ablation of liver lesions (n = 6,933) from 2005 to 2015. We estimated utilization over time and assessed differences in utilization and inpatient mortality across patient characteristics. Results In multivariate analysis, factors associated with utilization of services included treatment year, sex, race, insurance status, hospital type, and comorbidity burden, with black and Hispanic patients having statistically significantly decreased utilization. Factors associated with inpatient mortality included treatment year, sex, race, insurance status, hospital type, hospital region, and comorbidity burden, with black patients having a statistically significantly greater risk of inpatient mortality. Conclusion We identified racial and socioeconomic factors which were associated with utilization of services and inpatient mortality for patients with hepatitis C hepatocellular carcinoma. Blacks were especially disadvantaged in the receipt of care. Further work to abrogate these findings is imperative to ensure equitable provision of surgical therapies. |
| Databáze: | OpenAIRE |
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