Zerubabbel K Asfaw, Tirone Young, John Durbin, Lewis Tomalin, Isabelle M Germano
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引用次数: 0
Abstract
Background and objectives: Health care disparities are introduced at various points along the patient care continuum. This study explores disparities in initial health care access for patients with brain tumor (BT) in New York City (NYC) and New York State (NYS), comparing emergency department (ED) and elective admissions (EA).
Methods: Using 2010-2020 data from the Statewide Planning and Research Cooperative System of NYS, patients were identified through relevant billing codes. Demographic, socioeconomic, and health care access variables were examined using univariate analysis and logistic mixed effects regression. The data were dichotomized by care location-NYC or NYS- and entry care site, ED vs EA.
Results: The cross-sectional study included 48 135 patients. Over the decade, there was a significant decrease in the percentage of patients with BT admitted through the ED ( P < .001) without differences between the 2 cohorts. The NYC cohort (24 283 patients) had a higher proportion of younger, affluent individuals, racial/ethnic minorities, and publicly insured patients ( P < .001). Male sex and older age were significantly associated with ED admissions in both cohorts ( P < .05). Black, Hispanic/Latinx patients, and those with public health insurance were more likely to be admitted through ED ( P < .001). Residing in census tracts within the lowest 3 quartiles was positively associated with ED admission in the NYC but not the NYS cohort ( P < .001).
Conclusion: Racial minorities with public insurance who reside in urban areas of low median household income are more likely to access BT care through ED rather than EA. Additional studies are needed to evaluate the impact of proximity to a hospital on access to care in rural areas. This study highlights the opportunities for policy and health care delivery changes to address current inequities.
期刊介绍：
Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery.
Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.
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