Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Health Serv Res. 2013 Jun;48(3):1135-53. doi: 10.1111/1475-6773.12012. Epub 2012 Dec 3.
To examine disparities in utilization of gynecologic oncologists (GOs) across race and other sociodemographic factors for women with ovarian cancer.
Obtained SEER-Medicare linked dataset for 4,233 non-Hispanic White, non-Hispanic African American, Hispanic of any race, and Non-Hispanic Asian women aged ≥ 66 years old diagnosed with ovarian cancer during 2000-2002 from 17 SEER registries. Physician specialty was identified by linking data to the AMA master file using Unique Physician Identification Numbers.
Retrospective claims data analysis for 1999-2006. Logistic regression models were used to analyze the association between GO utilization and race/ethnicity in the initial, continuing, and final phases of care.
GO use decreased from the initial to final phase of care (51.4-28.8 percent). No racial/ethnic differences were found overall and by phase of cancer care. Women >70 years old and those with unstaged disease were less likely to receive GO care compared to their counterparts. GO use was lower in some SEER registries compared to the Atlanta registry.
GO use for the initial ovarian cancer treatment or for longer term care was low but not different across racial/ethnic groups. Future research should identify factors that affect GO utilization and understand why use of these specialists remains low.
考察卵巢癌患者在种族和其他社会人口因素方面利用妇科肿瘤学家（GO）的差异。
从 17 个 SEER 登记处获取了 2000-2002 年间诊断为卵巢癌的年龄≥66 岁的 4233 名非西班牙裔白人、非西班牙裔非裔美国人、任何种族的西班牙裔和非西班牙裔亚裔女性的 SEER-Medicare 关联数据集。通过使用唯一医师识别号码将数据与 AMA 主文件链接，确定医师专业。
1999-2006 年回顾性索赔数据分析。使用逻辑回归模型分析在初始、持续和最终治疗阶段，GO 利用率与种族/族裔之间的关联。
GO 的使用从初始治疗阶段下降到最终治疗阶段（51.4-28.8%）。总体上和按癌症治疗阶段均未发现种族/族裔差异。与同龄人相比，年龄>70 岁和未分期疾病的女性不太可能接受 GO 治疗。与亚特兰大登记处相比，一些 SEER 登记处的 GO 使用量较低。
GO 用于初始卵巢癌治疗或长期治疗的使用率较低，但在不同种族/族裔群体中没有差异。未来的研究应确定影响 GO 利用率的因素，并了解为何这些专家的使用率仍然较低。
