Disparities in Access to Thoracic Surgeons among Patients Receiving Lung Lobectomy in the United States

被引:2
|
作者
Halloran, Sean J. J. [1 ]
Alvarado, Christine E. E. [2 ]
Sarode, Anuja L. L. [3 ]
Jiang, Boxiang [2 ]
Sinopoli, Jillian [2 ]
Linden, Philip a A. [2 ]
Towe, Christopher W. W. [2 ]
机构
[1] Univ Toledo, Dept Surg, Coll Med & Life Sci, Toledo, OH 43614 USA
[2] Univ Hosp Cleveland Med Ctr, Dept Surg, Div Thorac & Esophageal Surg, 11100 Euclid Ave Cleveland, Cleveland, OH 44106 USA
[3] Univ Hosp Cleveland Med Ctr, Dept Surg, UH RISES Res Surg Outcomes & Effectiveness, Cleveland, OH 44160 USA
关键词
thoracic surgery; lung lobectomy; disparities; access to care; LONG-TERM SURVIVAL; THORACOSCOPIC LOBECTOMY; RACIAL DISPARITIES; AMERICAN-COLLEGE; CANCER SURGERY; STAGE-I; OUTCOMES; REGIONALIZATION; CARE; SPECIALIZATION;
D O I
10.3390/curroncol30030213
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: Lung lobectomy is the standard of care for early-stage lung cancer. Studies have suggested improved outcomes associated with lobectomy performed by specialized thoracic surgery providers. We hypothesized that disparities would exist regarding access to thoracic surgeons among patients receiving lung lobectomy for cancer. Methods: The Premier Hospital Database was used to identify adult inpatients receiving lung lobectomy from 2009 to 2019. Patients were categorized as receiving their lobectomy from a thoracic surgeon, cardiovascular surgeon, or general surgeon. Sample-weighted multivariable analysis was performed to identify factors associated with provider type. Results: When adjusted for sampling, 121,711 patients were analyzed, including 71,709 (58.9%) who received lobectomy by a thoracic surgeon, 36,630 (30.1%) by a cardiovascular surgeon, and 13,373 (11.0%) by a general surgeon. Multivariable analysis showed that thoracic surgeon provider type was less likely with Black patients, Medicaid insurance, smaller hospital size, in the western region, and in rural areas. In addition, non-thoracic surgery specialty was less likely to perform minimally-invasive (MIS) lobectomy (cardiovascular OR 0.80, p < 0.001, general surgery OR 0.85, p = 0.003). Conclusions: In this nationally representative analysis, smaller, rural, non-teaching hospitals, and certain regions of the United States are less likely to receive lobectomy from a thoracic surgeon. Thoracic surgeon specialization is also independently associated with utilization of minimally invasive lobectomy. Combined, there are significant disparities in access to guideline-directed surgical care of patients receiving lung lobectomy.
引用
收藏
页码:2801 / 2811
页数:11
相关论文
共 50 条
  • [41] Health Care Access Measures and Palliative Care Use by Race/Ethnicity among Metastatic Gynecological Cancer Patients in the United States
    Islam, Jessica Y.
    Saraiya, Veeral
    Previs, Rebecca A.
    Akinyemiju, Tomi
    INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 2021, 18 (11)
  • [42] Disparities in limb preservation and associated socioeconomic burden among patients with diabetes and/or peripheral artery disease in the United States
    McDermott, Katherine M.
    Bose, Sanuja
    Keegan, Alana
    Hicks, Caitlin W.
    SEMINARS IN VASCULAR SURGERY, 2023, 36 (01) : 39 - 48
  • [43] Worsening racial disparities in patients undergoing anatomic and reverse total shoulder arthroplasty in the United States
    Best, Matthew J.
    Aziz, Keith T.
    McFarland, Edward G.
    Martin, Scott D.
    Rue, John-Paul H.
    Srikumaran, Uma
    JOURNAL OF SHOULDER AND ELBOW SURGERY, 2021, 30 (08) : 1844 - 1850
  • [44] Racial Disparities in Cardiovascular Disease Among Patients with Cancer in the United States: The Elephant in the Room
    Thotamgari, Sahith Reddy
    Sheth, Aakash Rajendra
    Grewal, Udhayvir Singh
    ECLINICALMEDICINE, 2022, 44
  • [45] Disparities Among Cervical Cancer Patients Receiving Brachytherapy
    Bruce, Shaina F.
    Joshi, Tanvi V.
    Chervoneva, Inna
    Yi, Misung
    Chatterjee-Paer, Sudeshna
    Burton, Elizabeth R.
    Edelson, Mitchell I.
    Sorosky, Joel I.
    Shahin, Mark S.
    OBSTETRICS AND GYNECOLOGY, 2019, 134 (03) : 559 - 569
  • [46] Time to treatment disparities in gastric cancer patients in the United States of America: a comprehensive retrospective analysis
    Sharan, Seema
    Bansal, Shivam
    Manaise, Harsheen Kaur
    Jimenez, Paola Berrios
    Raikot, Swathi R.
    Ahmed, Syeda Hoorulain
    Popp, Reed
    Popp, Kyle
    Sukniam, Kulkaew
    Kowkabany, Gabrielle
    Mubarak, Fatima
    Gabriel, Emmanuel
    FRONTIERS IN ONCOLOGY, 2024, 14
  • [47] Academic Rank and Productivity Among United States Cardiothoracic Surgeons
    Norton, Elizabeth L.
    Castro-Varela, Alejandra
    Figueredo, Jessica
    Do-Nguyen, Chi Chi
    Russell, Jacqueline L.
    Qiu, Julie
    Luc, Jessica G. Y.
    Hirji, Sameer
    Miter, Sarah L.
    ANNALS OF THORACIC SURGERY, 2023, 116 (05) : 1091 - 1097
  • [48] Racial disparities in survival among patients with germ cell tumors of the ovary - United States
    Bryant, Christopher S.
    Kumar, Sanjeev
    Shah, Jay P.
    Mahdi, Haider
    Ali-Fehmi, Rouba
    Munkarah, Adnan R.
    Deppe, Gunter
    Morris, Robert T.
    GYNECOLOGIC ONCOLOGY, 2009, 114 (03) : 437 - 441
  • [49] Access to Lung Transplantation in the United States: The Potential Impact of Access to a High-volume Center
    Chan, Ernest G.
    Hayanga, J. W. Awori
    Tuft, Marie
    Morrell, Matthew R.
    Sanchez, Pablo G.
    TRANSPLANTATION, 2020, 104 (07) : E199 - E207
  • [50] Regional disparities in access to verified burn center care in the United States
    Carmichael, Heather
    Wiktor, Arek J.
    McIntyre, Robert C.
    Wagner, Anne Lambert
    Velopulos, Catherine G.
    JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, 2019, 87 (01) : 111 - 116