Abstract 2627: Socioeconomic status and utilization of major surgical procedures in the United States, Canada, and Australia

Abstract

Purpose: This study aimed to compare the utilization rates of three organ resection surgeries, predominantly indicated for the treatment of cancer, in the US, Canada, and Australia, and compare rates between residents of lower- and higher-income neighborhoods. Methods: We used population-based administrative data to identify all adults aged ≥18 years hospitalized for pancreatectomy (PX), radical prostatectomy (RP) and nephrectomy (NX) between 2011-2016 (New York, USA), 2011-2018 (Ontario, Canada), and 2013-2018 (New South Wales, Australia). We linked each patient9s zip-code of residence to 2016 census data to ascertain neighborhood income. We compared utilization rates for each procedure in each jurisdiction in aggregate and by neighborhood income quintile. Primary outcomes were: 1) each jurisdictions9 per-capita overall, age-, and sex-standardized utilization rates for each procedure; and 2) utilization rates amongst residents of lower- and higher-income neighborhoods. Results: Sociodemographics were similar across jurisdictions; patients in New South Wales were older for all procedures. New York hospitals were significantly likelier to perform each of the three procedures compared to Ontario and New South Wales (all P Conclusions: Utilization rates of PX, RP, and NX were significantly higher in New York and New South Wales than in Ontario. Rich-poor surgical utilization differences were significantly larger in New York and New South Wales and significantly smaller in Ontario. These findings suggest that income-based disparities are larger in US and Australian jurisdictions than those Canadian, and highlight the possible trade-offs of equity and access in cancer care of different countries. Citation Format: Hilary Pang, Kelsey Chalmers, Bruce Landon, Adam Elshaug, John Matelski, Vicki Ling, Monika K. Krzyzanowska, Girish Kulkarni, Bradley A. Erickson, Peter Cram. Socioeconomic status and utilization of major surgical procedures in the United States, Canada, and Australia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2627.