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Examining the role of access to care: Racial/ethnic differences in receipt of resection for early-stage non-small cell lung cancer among integrated system members and non-members.

Publication ,  Journal Article
Check, DK; Albers, KB; Uppal, KM; Suga, JM; Adams, AS; Habel, LA; Quesenberry, CP; Sakoda, LC
Published in: Lung Cancer
November 2018

OBJECTIVES: To examine the role of uniform access to care in reducing racial/ethnic disparities in receipt of resection for early stage non-small cell lung cancer (NSCLC) by comparing integrated health system member patients to demographically similar non-member patients. MATERIALS AND METHODS: Using data from the California Cancer Registry, we conducted a retrospective cohort study of patients from four racial/ethnic groups (White, Black, Hispanic, Asian/Pacific Islander), aged 21-80, with a first primary diagnosis of stage I or II NSCLC between 2004 and 2011, in counties served by Kaiser Permanente Northern California (KPNC) at diagnosis. Our cohort included 1565 KPNC member and 4221 non-member patients. To examine the relationship between race/ethnicity and receipt of surgery stratified by KPNC membership, we used modified Poisson regression to calculate risk ratios (RR) adjusted for patient demographic and tumor characteristics. RESULTS: Black patients were least likely to receive surgery regardless of access to integrated care (64-65% in both groups). The magnitude of the black-white difference in the likelihood of surgery receipt was similar for members (RR: 0.82, 95% CI: 0.73-0.93) and non-members (RR: 0.86, 95% CI: 0.80-0.94). Among members, roughly equal proportions of Hispanic and White patients received surgery; however, among non-members, Hispanic patients were less likely to receive surgery (non-members, RR: 0.93, 95% CI: 0.86-1.00; members, RR: 0.98, 95% CI: 0.89-1.08). CONCLUSION: Disparities in surgical treatment for NSCLC were not reduced through integrated health system membership, suggesting that factors other than access to care (e.g., patient-provider communication) may underlie disparities. Future research should focus on identifying such modifiable factors.

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Published In

Lung Cancer

DOI

EISSN

1872-8332

Publication Date

November 2018

Volume

125

Start / End Page

51 / 56

Location

Ireland

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Population Groups
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Healthcare Disparities
  • Health Services Accessibility
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Check, D. K., Albers, K. B., Uppal, K. M., Suga, J. M., Adams, A. S., Habel, L. A., … Sakoda, L. C. (2018). Examining the role of access to care: Racial/ethnic differences in receipt of resection for early-stage non-small cell lung cancer among integrated system members and non-members. Lung Cancer, 125, 51–56. https://doi.org/10.1016/j.lungcan.2018.09.006
Check, Devon K., Kathleen B. Albers, Kanti M. Uppal, Jennifer Marie Suga, Alyce S. Adams, Laurel A. Habel, Charles P. Quesenberry, and Lori C. Sakoda. “Examining the role of access to care: Racial/ethnic differences in receipt of resection for early-stage non-small cell lung cancer among integrated system members and non-members.Lung Cancer 125 (November 2018): 51–56. https://doi.org/10.1016/j.lungcan.2018.09.006.
Check, Devon K., et al. “Examining the role of access to care: Racial/ethnic differences in receipt of resection for early-stage non-small cell lung cancer among integrated system members and non-members.Lung Cancer, vol. 125, Nov. 2018, pp. 51–56. Pubmed, doi:10.1016/j.lungcan.2018.09.006.
Check DK, Albers KB, Uppal KM, Suga JM, Adams AS, Habel LA, Quesenberry CP, Sakoda LC. Examining the role of access to care: Racial/ethnic differences in receipt of resection for early-stage non-small cell lung cancer among integrated system members and non-members. Lung Cancer. 2018 Nov;125:51–56.
Journal cover image

Published In

Lung Cancer

DOI

EISSN

1872-8332

Publication Date

November 2018

Volume

125

Start / End Page

51 / 56

Location

Ireland

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Population Groups
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Healthcare Disparities
  • Health Services Accessibility