| Title |
The influence of race/ethnicity and place of service on breast reconstruction for Medicare beneficiaries with mastectomy
|
|---|---|
| Published in |
SpringerPlus, August 2014
|
| DOI | 10.1186/2193-1801-3-416 |
| Pubmed ID | |
| Authors |
Tracy Onega, Julie Weiss, Karla Kerlikowske, Karen Wernli, Diana SM Buist, Louise M Henderson, Martha Goodrich, Jennifer Alford-Teaster, Beth Virnig, Anna NA Tosteson, Wendy DeMartini, Rebecca Hubbard |
| Abstract |
Racial disparities in breast reconstruction for breast cancer are documented. Place of service has contributed to disparities in cancer care; but the interaction of race/ethnicity and place of service has not been explicitly examined. We examined whether place of service modified the effect of race/ethnicity on receipt of reconstruction. We included women with a mastectomy for incident breast cancer in SEER-Medicare from 2005-2009. Using Medicare claims, we determined breast reconstruction within 6 months. Facility characteristics included: rural/urban location, teaching status, NCI Cancer Center designation, cooperative oncology group membership, Disproportionate Share Hospital (DSH) status, and breast surgery volume. Using multivariable logistic regression, we analyzed reconstruction in relation to minority status and facility characteristics. Of the 17,958 women, 14.2% were racial/ethnic women of color and a total of 9.3% had reconstruction. Caucasians disproportionately received care at non-teaching hospitals (53% v. 42%) and did not at Disproportionate Share Hospitals (77% v. 86%). Women of color had 55% lower odds of reconstruction than Caucasians (OR = 0.45; 95% CI 0.37-0.55). Those in lower median income areas had lower odds of receiving reconstruction, regardless of race/ethnicity. Odds of reconstruction reduced at rural, non-teaching and cooperative oncology group hospitals, and lower surgery volume facilities. Facility effects on odds of reconstruction were similar in analyses stratified by race/ethnicity status. Race/ethnicity and facility characteristics have independent effects on utilization of breast reconstruction, with no significant interaction. This suggests that, regardless of a woman's race/ethnicity, the place of service influences the likelihood of reconstruction. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Belgium | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 27 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Doctoral Student | 4 | 15% |
| Student > Postgraduate | 4 | 15% |
| Other | 3 | 11% |
| Researcher | 3 | 11% |
| Student > Ph. D. Student | 1 | 4% |
| Other | 3 | 11% |
| Unknown | 9 | 33% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 44% |
| Social Sciences | 4 | 15% |
| Biochemistry, Genetics and Molecular Biology | 1 | 4% |
| Business, Management and Accounting | 1 | 4% |
| Unknown | 9 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 43. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 September 2014.
All research outputs
#806,339
of 22,763,032 outputs
Outputs from SpringerPlus
#32
of 1,852 outputs
Outputs of similar age
#8,616
of 230,512 outputs
Outputs of similar age from SpringerPlus
#2
of 103 outputs
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