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肝癌患者在急诊科就诊中种族/民族和社会经济地位的作用。

Race/ethnicity and socioeconomic position in emergency department utilization in patients with hepatocellular carcinoma.

机构信息

Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

Public Affairs and Access, Genentech, Inc., South San Francisco, CA 94080, USA.

出版信息

Future Oncol. 2024;20(24):1765-1777. doi: 10.2217/fon-2023-0412. Epub 2024 Apr 19.

DOI:10.2217/fon-2023-0412
PMID:38639552
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11486108/
Abstract

Evaluate the association of race/ethnicity and socioeconomic position (SEP) on emergency department (ED) visits for patients with hepatocellular carcinoma (HCC), which may reflect access to and quality of cancer care. Patients with HCC identified from a commercial multi-payer claims database between 2015 and 2018 were matched to near-neighborhood social determinants of health (SDOH) and stratified by race/ethnicity and SEP (proxied by annual household income). Analyses evaluated the effect of race/ethnicity and SEP on ED utilization, adjusting for SDOH, demographic and clinical characteristics using multivariable regression methods. A total of 22,247 patients were included. Black and Hispanic patients had 43 and 18% higher ED utilization than White patients at higher-income levels (p < 0.01); these differences were nonsignificant at lower-income. Regardless of income level, Asian patients had lower ED utilization. Further research on the intersectionality between race/ethnicity, SEP and other SDOH may guide structural-level interventions to address health inequities.

摘要

评估种族/民族和社会经济地位（SEP）对肝细胞癌（HCC）患者急诊就诊的影响，这可能反映了获得和癌症治疗的质量。从 2015 年至 2018 年的商业多付款人索赔数据库中确定 HCC 患者，并按种族/民族和 SEP（由年收入表示）与附近健康的社会决定因素（SDOH）进行匹配。使用多变量回归方法，分析评估了种族/民族和 SEP 对 ED 利用率的影响，调整了 SDOH、人口统计学和临床特征。共纳入 22247 名患者。在高收入水平下，黑人和西班牙裔患者的 ED 利用率比白人患者高 43%和 18%（p<0.01）；在低收入水平下，这些差异无统计学意义。无论收入水平如何，亚洲患者的 ED 利用率较低。关于种族/民族、SEP 和其他 SDOH 之间的交叉性的进一步研究可以指导结构层面的干预措施，以解决健康不平等问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ef/11486108/64457c662dd8/IFON_A_2339673_F0004_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ef/11486108/cea9e223f58f/IFON_A_2339673_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ef/11486108/59770e2c7c0d/IFON_A_2339673_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ef/11486108/68e590640761/IFON_A_2339673_F0003_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ef/11486108/64457c662dd8/IFON_A_2339673_F0004_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ef/11486108/cea9e223f58f/IFON_A_2339673_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ef/11486108/59770e2c7c0d/IFON_A_2339673_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ef/11486108/68e590640761/IFON_A_2339673_F0003_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ef/11486108/64457c662dd8/IFON_A_2339673_F0004_C.jpg

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Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma.
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