Evaluating disparities in inpatient surgical cancer care among American Indian/Alaska Native patients

被引：14

作者：

Simianu, Vlad V. ^{[1
]}

Morris, Arden M. ^{[2
]}

Varghese, Thomas K., Jr. ^{[1
]}

Porter, Michael P. ^{[3
]}

Henderson, Jeffrey A. ^{[4
]}

Buchwald, Dedra S. ^{[5
]}

Flum, David R. ^{[1
]}

Javid, Sara H. ^{[1
]}

机构：

[1] Univ Washington, Dept Surg, Surg Outcomes Res Ctr, UW Med Ctr, Box 354808,1107 NE 45th St,Suite 502, Seattle, WA 98105 USA

[2] Univ Michigan, Dept Surg, Ann Arbor, MI 48109 USA

[3] Univ Washington, Dept Urol, Seattle, WA 98195 USA

[4] Black Hills Ctr Amer Indian Hlth, Rapid City, SD USA

[5] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

来源：

AMERICAN JOURNAL OF SURGERY | 2016年 / 212卷 / 02期

关键词：

American Indian/Alaska Natives; Cancer; Surgery; Process of care; CLINICAL-PRACTICE GUIDELINES; RACIAL MISCLASSIFICATION; HEALTH-CARE; BREAST; SURVIVAL; OUTCOMES; QUALITY; SURGERY; INDIANS; LUNG;

D O I：

10.1016/j.amjsurg.2015.10.030

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: American Indian/Alaska Native (AI/AN) patients with cancer have the lowest survival rates of all racial and ethnic groups, possibly because they are less likely to receive "best practice" surgical care than patients of other races. METHODS: Prospective cohort study comparing adherence with generic and cancer-specific guidelines on processes of surgical care between AI/AN and non-Hispanic white (NHW) patients in Washington State (2010 to 2014) was conducted. RESULTS: A total of 156 AI/AN and 6,030 NHW patients underwent operations for 10 different cancers, and had similar mean adherence to generic surgical guidelines (91.5% vs 91.9%, P = .57). AI/AN patients with breast cancer less frequently received preoperative diagnostic core needle biopsy (81% vs 94%, P = .004). AI/AN patients also less frequently received care adherent to prostate cancer-specific guidelines (74% vs 92%, P = .001). CONCLUSION: Although AI/ANs undergoing cancer operations in Washington receive similar overall best practice surgical cancer care to NHW patients, there remain important, modifiable disparities that may contribute to their lower survival. (C) 2016 Elsevier Inc. All rights reserved.

引用

页码：297 / 304

页数：8

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