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- Title
Time to Treatment for Patients Receiving BCS in a Public and a Private University Hospital in Atlanta.
- Authors
Mosunjac, Marina; Park, Jaemin; Strauss, Alexandra; Birdsong, George; Du, Victor; Rizzo, Monica; Gabram, Sheryl G. A.; Lund, Mary Jo
- Abstract
Delays in treatment for breast cancer can lead to poorer patient outcome. We analyzed time to treatment among female patients receiving breast-conserving surgery in two different hospital settings, public versus private. Retrospective chart review revealed 270 patients diagnosed during 2004-2008. Three consecutive time intervals were defined (Initial abnormal imaging [I] to core biopsy [II] to surgery /pathology staging [III] to oncology evaluation for adjuvant treatment). Multivariate analyses investigated hospital type and demographic factors. Overall median treatment time was 83 days, Interval II accounting for the longest (43 days). Only 55% of patients received the entire spectrum of care within 90 days; for each consecutive 30-day interval, percentages varied dramatically: 80.7%, 31.1%, and 68.9%.Public hospital patients experienced longer overall time to treatment than private patients (94 versus 77 days, p < 0.001); these differences persisted throughout the intervals. Longer wait times were experienced by African Americans versus Caucasians (89 versus 64 days, p = 0.003), unmarried versus married patients (93 versus 70 days, p < 0.001), and Medicaid-insured patients, p < 0.001. In multivariate analyses, hospital type, race, marital status, and insurance predicted timely treatment within one or more intervals. For patients undergoing breast-conserving therapy, time to treatment differs between private and public settings. However, barriers to timely treatment arise from both system-based issues and patient socio-demographic factors. Studies are needed to evaluate and intervene on this intricate connection.
- Subjects
GEORGIA; BLACK people; BREAST tumors; CHI-squared test; CONFIDENCE intervals; EPIDEMIOLOGY; FISHER exact test; PROBABILITY theory; PUBLIC hospitals; RACE; STATISTICS; TIME; WHITE people; DATA analysis; MULTIPLE regression analysis; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics
- Publication
Breast Journal, 2012, Vol 18, Issue 2, p163
- ISSN
1075-122X
- Publication type
Article
- DOI
10.1111/j.1524-4741.2011.01205.x