Identifying the barriers to gastric cancer care at safety-net hospitals: A novel comparison of a safety-net hospital to a neighboring quaternary referral academic center in the same healthcare system.


BACKGROUND:The three-delays model describes delays in seeking, reaching, and receiving care for vulnerable populations needing treatment. The dominant delay for patients with gastric adenocarcinoma (GAC) is unknown. We aimed to define patients with GAC who reached and received care at our regional safety-net hospital (Grady Memorial Hospital [GMH]) and our neighboring quaternary referral hospital (Emory University Hospital [EUH]). METHODS:Clinicopathologic data from National Cancer Database (NCDB) participating academic centers were compared with GMH from 2004 to 2014. Outcomes of patients undergoing surgery at GMH were compared to those at EUH. RESULTS:At presentation, compared to NCDB centers (n = 69 662), GMH patients (n = 154) were more often black (85.1 vs 17.2%; P < 0.001), uninsured (30.5 vs 4.7%; P < 0.001), have stage IV disease (43.5 vs 30.1%; P = 0.017), and received no treatment (40.3 vs 18.4%; P < 0.001). When only comparing patients who underwent curative-intent resection at GMH (n = 23) to EUH (n = 137), median overall survival was similar between both groups (GMH: median not reached; EUH: 59.8 mos; P = 0.785). CONCLUSION:Although vulnerable patients with GAC within a safety-net hospital present with later stages of the disease, those who received surgery have acceptable outcomes. Thus, efforts should be made to overcome barriers in seeking care.


J Surg Oncol


Zaidi MY,Rappaport JM,Ethun CG,Gillespie T,Hawk N,Chawla S,Cardona K,Maithel SK,Russell MC




Has Abstract


2019-01-01 00:00:00












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    journal_title:Journal of surgical oncology

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    journal_title:Journal of surgical oncology

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    pub_type: 杂志文章


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    journal_title:Journal of surgical oncology

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  • Predictors of surgical quality for retroperitoneal sarcoma: Volume matters.

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    journal_title:Journal of surgical oncology

    pub_type: 杂志文章


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    journal_title:Journal of surgical oncology

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    journal_title:Journal of surgical oncology

    pub_type: 杂志文章,评审


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    journal_title:Journal of surgical oncology

    pub_type: 杂志文章


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    journal_title:Journal of surgical oncology

    pub_type: 杂志文章


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    journal_title:Journal of surgical oncology

    pub_type: 杂志文章


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    更新日期:1998-07-01 00:00:00