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- Title
An Elephant in the Emergency Department: Symptom of Disparities in Cancer Care.
- Authors
Livingood, William C.; Smotherman, Carmen; Lukens-Bull, Katryne; Aldridge, Petra; Kraemer, Dale F.; Wood, David L.; Volpe, Carmine
- Abstract
Reliance on emergency departments (EDs) by economically disadvantaged people for initial cancer diagnosis in place of primary care and early diagnosis and treatment is 1 obvious plausible explanation for cancer disparities. Claims data from a safety net hospital for the years 2009-2010 were merged with hospital tumor registry data to compare hospitalizations for ED-associated initial cancer diagnoses to non-ED associated initial diagnoses. The proportion of initial cancer diagnoses associated with hospital admissions through the ED was relatively high (32%) for all safety net hospital patients, but disproportionately higher for African Americans and residents of the impoverished urban core. Use of the ED for initial diagnosis was associated with a 75% higher risk of stage 4 versus stage 1 cancer diagnosis, and a 176% higher risk of dying during the 2-year study period. Findings from this study of ED use within a safety net hospital documented profound disparities in cancer care and outcomes with major implications for monitoring disparities, Affordable Care Act impact, and safety net hospital utilization. ( Population Health Management 2016;19:95-101)
- Subjects
UNITED States; FLORIDA; TUMOR treatment; PRACTICAL politics; ASIANS; BLACK people; HEALTH services accessibility; HEALTH status indicators; HISPANIC Americans; HOSPITAL emergency services; NATIVE Americans; HEALTH insurance; MEDICAID; MEDICAL care use; MEDICARE; SURVIVAL; WHITE people; SOCIOECONOMIC factors; PATIENT Protection &; Affordable Care Act; SAFETY-net health care providers
- Publication
Population Health Management, 2016, Vol 19, Issue 2, p95
- ISSN
1942-7891
- Publication type
Article
- DOI
10.1089/pop.2015.0118