caa a22 4500 445339187 CHVBK 20180317142806.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-2001-z doi (NATIONALLICENCE)springer-10.1245/s10434-011-2001-z Socioeconomic and Racial Differences in Treatment for Breast Cancer at a Low-Volume Hospital [Elektronische Daten] [Amanda Kong, Tina Yen, Liliana Pezzin, Haiyan Miao, Rodney Sparapani, Purushottam Laud, Ann Nattinger] Purpose: Population-based studies have revealed higher mortality among breast cancer patients treated in low-volume hospitals. Other studies have demonstrated disparities in race and socioeconomic status (SES) in breast cancer survival. The purpose of our study was to determine whether nonwhite or low-SES patients are disproportionately treated in low-volume hospitals. Methods: A population-based cohort of 2,777 Medicare breast cancer patients who underwent breast cancer surgery in 2003 participated in a survey study examining breast cancer outcomes. Information was obtained from survey responses, Medicare claims, and state tumor registry data. Results: On univariate analysis, patients treated at low-volume hospitals were less likely to be white, less likely to live in an urban location, and more likely to have a low SES with less social support and live a greater distance from a high-volume hospital. Education, marital status, total household income, having additional insurance besides Medicare, population density of primary residence, and tangible support were associated with distance to the nearest high-volume hospital. On multivariate analysis, the independent predictors of treatment at a low-volume hospital were being nonwhite (P=0.003), having a lower household income (P<0.0001), residence in a rural location (P=0.01), and living a greater distance from a high-volume hospital (P<0.0001). Conclusions: In this large population-based cohort, women who were poorer, nonwhite, and who lived in a rural location or at a greater distance from a high-volume hospital were more likely to be treated at low-volume hospitals. These differences may partially explain racial and SES disparities in breast cancer outcomes. Society of Surgical Oncology, 2011 Kong Amanda Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut Yen Tina Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut Pezzin Liliana Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA aut Miao Haiyan Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA aut Sparapani Rodney Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA aut Laud Purushottam Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA aut Nattinger Ann Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA aut Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3220-3227 1068-9265 18:11<3220 2011 18 10434 https://doi.org/10.1245/s10434-011-2001-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-2001-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kong Amanda Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Yen Tina Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Pezzin Liliana Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Miao Haiyan Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Sparapani Rodney Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Laud Purushottam Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Nattinger Ann Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3220-3227 1068-9265 18:11<3220 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer