Abstract:
:Reliance on emergency departments (EDs) by economically disadvantaged people for initial cancer diagnosis in place of primary care and early diagnosis and treatment is 1 obvious plausible explanation for cancer disparities. Claims data from a safety net hospital for the years 2009-2010 were merged with hospital tumor registry data to compare hospitalizations for ED-associated initial cancer diagnoses to non-ED associated initial diagnoses. The proportion of initial cancer diagnoses associated with hospital admissions through the ED was relatively high (32%) for all safety net hospital patients, but disproportionately higher for African Americans and residents of the impoverished urban core. Use of the ED for initial diagnosis was associated with a 75% higher risk of stage 4 versus stage 1 cancer diagnosis, and a 176% higher risk of dying during the 2-year study period. Findings from this study of ED use within a safety net hospital documented profound disparities in cancer care and outcomes with major implications for monitoring disparities, Affordable Care Act impact, and safety net hospital utilization. (Population Health Management 2016;19:95-101).
journal_name
Popul Health Managjournal_title
Population health managementauthors
Livingood WC,Smotherman C,Lukens-Bull K,Aldridge P,Kraemer DF,Wood DL,Volpe Cdoi
10.1089/pop.2015.0118subject
Has Abstractpub_date
2016-04-01 00:00:00pages
95-101issue
2eissn
1942-7891issn
1942-7905journal_volume
19pub_type
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