Disparities in Access to Autologous Breast Reconstruction
<i>Background and objectives:</i><b> </b>This study aimed to determine if age, race, region, insurance, and comorbidities affect the type of breast reconstruction that patients receive. <i>Materials and methods:</i><b> </b>This analysis used the Florid...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2020-06-01
|
Series: | Medicina |
Subjects: | |
Online Access: | https://www.mdpi.com/1010-660X/56/6/281 |
id |
doaj-8e3f6deaaa924002b6f3a8354672b6d0 |
---|---|
record_format |
Article |
spelling |
doaj-8e3f6deaaa924002b6f3a8354672b6d02020-11-25T03:54:20ZengMDPI AGMedicina1010-660X2020-06-015628128110.3390/medicina56060281Disparities in Access to Autologous Breast ReconstructionDavid J. Restrepo0Maria T. Huayllani1Daniel Boczar2Andrea Sisti3Minh-Doan T. Nguyen4Jordan J. Cochuyt5Aaron C. Spaulding6Brian D. Rinker7Galen Perdikis8Antonio J. Forte9Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USADivision of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USADivision of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USADepartment of Plastic Surgery, Cleveland Clinic, OH 44195, USADivision of Plastic Surgery, Mayo Clinic, Rochester, MN 55905, USADepartment of Health Science Research, Mayo Clinic, Jacksonville, FL 32224, USADepartment of Health Science Research, Mayo Clinic, Jacksonville, FL 32224, USADivision of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USADepartment of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USADivision of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA<i>Background and objectives:</i><b> </b>This study aimed to determine if age, race, region, insurance, and comorbidities affect the type of breast reconstruction that patients receive. <i>Materials and methods:</i><b> </b>This analysis used the Florida Inpatient Discharge Dataset from 1 January 2013 to 30 September 2017, which contains deidentified patient-level administrative data from all acute care hospitals in the state of Florida. We included female patients, diagnosed with breast cancer, who underwent mastectomy and a subsequent breast reconstruction. We performed an χ<sup>2</sup> test and logistic regression in this analysis. <i>Results:</i><b> </b>On the multivariable analysis, we found that age, race, patient region, insurance payer, and Elixhauser score were all variables that significantly affected the type of reconstruction that patients received. Our results show that African American (odds ratio (OR): 0.68, 95%CI: 0.58–0.78, <i>p</i> < 0.001) and Hispanic or Latino (OR: 0.82, 95%CI: 0.72–0.93, <i>p</i> = 0.003) patients have significantly lower odds of receiving implant reconstruction when compared to white patients. Patients with Medicare (OR: 1.57, 95%CI: 1.33–1.86, <i>p</i> < 0.001) had significantly higher odds and patients with Medicaid (OR: 0.61, 95%CI: 0.51–0.74, <i>p</i> < 0.001) had significantly lower odds of getting autologous reconstruction when compared to patients with commercial insurance. <i>Conclusions:</i><b> </b>Our study demonstrated that, in the state of Florida over the past years, variables, such as race, region, insurance, and comorbidities, play an important role in choosing the reconstruction modality. More efforts are needed to eradicate disparities and give all patients, despite their race, insurance payer, or region, equal access to health care.https://www.mdpi.com/1010-660X/56/6/281breast cancerbreast reconstructionautologous reconstructiondisparitiespublic healthFlorida |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David J. Restrepo Maria T. Huayllani Daniel Boczar Andrea Sisti Minh-Doan T. Nguyen Jordan J. Cochuyt Aaron C. Spaulding Brian D. Rinker Galen Perdikis Antonio J. Forte |
spellingShingle |
David J. Restrepo Maria T. Huayllani Daniel Boczar Andrea Sisti Minh-Doan T. Nguyen Jordan J. Cochuyt Aaron C. Spaulding Brian D. Rinker Galen Perdikis Antonio J. Forte Disparities in Access to Autologous Breast Reconstruction Medicina breast cancer breast reconstruction autologous reconstruction disparities public health Florida |
author_facet |
David J. Restrepo Maria T. Huayllani Daniel Boczar Andrea Sisti Minh-Doan T. Nguyen Jordan J. Cochuyt Aaron C. Spaulding Brian D. Rinker Galen Perdikis Antonio J. Forte |
author_sort |
David J. Restrepo |
title |
Disparities in Access to Autologous Breast Reconstruction |
title_short |
Disparities in Access to Autologous Breast Reconstruction |
title_full |
Disparities in Access to Autologous Breast Reconstruction |
title_fullStr |
Disparities in Access to Autologous Breast Reconstruction |
title_full_unstemmed |
Disparities in Access to Autologous Breast Reconstruction |
title_sort |
disparities in access to autologous breast reconstruction |
publisher |
MDPI AG |
series |
Medicina |
issn |
1010-660X |
publishDate |
2020-06-01 |
description |
<i>Background and objectives:</i><b> </b>This study aimed to determine if age, race, region, insurance, and comorbidities affect the type of breast reconstruction that patients receive. <i>Materials and methods:</i><b> </b>This analysis used the Florida Inpatient Discharge Dataset from 1 January 2013 to 30 September 2017, which contains deidentified patient-level administrative data from all acute care hospitals in the state of Florida. We included female patients, diagnosed with breast cancer, who underwent mastectomy and a subsequent breast reconstruction. We performed an χ<sup>2</sup> test and logistic regression in this analysis. <i>Results:</i><b> </b>On the multivariable analysis, we found that age, race, patient region, insurance payer, and Elixhauser score were all variables that significantly affected the type of reconstruction that patients received. Our results show that African American (odds ratio (OR): 0.68, 95%CI: 0.58–0.78, <i>p</i> < 0.001) and Hispanic or Latino (OR: 0.82, 95%CI: 0.72–0.93, <i>p</i> = 0.003) patients have significantly lower odds of receiving implant reconstruction when compared to white patients. Patients with Medicare (OR: 1.57, 95%CI: 1.33–1.86, <i>p</i> < 0.001) had significantly higher odds and patients with Medicaid (OR: 0.61, 95%CI: 0.51–0.74, <i>p</i> < 0.001) had significantly lower odds of getting autologous reconstruction when compared to patients with commercial insurance. <i>Conclusions:</i><b> </b>Our study demonstrated that, in the state of Florida over the past years, variables, such as race, region, insurance, and comorbidities, play an important role in choosing the reconstruction modality. More efforts are needed to eradicate disparities and give all patients, despite their race, insurance payer, or region, equal access to health care. |
topic |
breast cancer breast reconstruction autologous reconstruction disparities public health Florida |
url |
https://www.mdpi.com/1010-660X/56/6/281 |
work_keys_str_mv |
AT davidjrestrepo disparitiesinaccesstoautologousbreastreconstruction AT mariathuayllani disparitiesinaccesstoautologousbreastreconstruction AT danielboczar disparitiesinaccesstoautologousbreastreconstruction AT andreasisti disparitiesinaccesstoautologousbreastreconstruction AT minhdoantnguyen disparitiesinaccesstoautologousbreastreconstruction AT jordanjcochuyt disparitiesinaccesstoautologousbreastreconstruction AT aaroncspaulding disparitiesinaccesstoautologousbreastreconstruction AT briandrinker disparitiesinaccesstoautologousbreastreconstruction AT galenperdikis disparitiesinaccesstoautologousbreastreconstruction AT antoniojforte disparitiesinaccesstoautologousbreastreconstruction |
_version_ |
1724474199424106496 |