Debraj Mukherjee
Disparities in Access to Neuro-oncologic Care in the United States
Johns Hopkins Medicine
raceethnicity social status influence admission highvolume hospitals among patients undergo craniotomy tumor biopsy resectionretrospective analysis nationwide inpatient sample 19882005 additional factors area resource filea 20 representative sample hospitals 37 us statesa total 76 436 patients 18 years older admitted underwent craniotomy tumor biopsy resectionodds ratios ors association age sex raceethnicity insurance status charlson comorbidity index countylevel characteristics admission highvolume hospitals 50 craniotomies per year lowvolume hospitalsa total 25 481 patients 333 admitted highvolume hospitals overall access highvolume hospitals improved time however racialethnic disparities access highvolume hospitals dramatically worsened hispanics 049 african americans 062 recent years factors associated better access highvolume hospitals included years since 1988 111 greater countywide neurosurgeon density 166 higher countywide median household income 171 factors associated worse access highvolume hospitals included older age 034 per year increase increased countywide poverty rate 057 hispanic raceethnicity 068 higher charlson comorbidity index 096 per point increaseafrican americans hispanics disproportionately worse access highquality neurooncologic care time compared whites higher countywide median household income decreased countywide poverty rate associated better access highvolume hospitals implicating socioeconomic factors predicting admission highquality centers