Rachel A. Freedman|Elena M. Kouri|Dee W. West|Nancy L. Keating
Racial/Ethnic Differences in Patients’ Selection of Surgeons and Hospitals for Breast Cancer Surgery
Dana-Farber Cancer Institute|Harvard University|Public Health Institute|Brigham and Women's Hospital|Harvard University
racial differences breast cancer treatment may result part differences surgeons hospitals patients receive care however little known differences patients selection surgeons hospitalsto examine racialethnic differences women selected surgeons hospitals breast cancer surgerywe surveyed 500 women 222 nonhispanic white 142 nonhispanic black 89 englishspeaking hispanic 47 spanishspeaking hispanic northern california cancer registries stage 0 iii breast cancer diagnosed 2010 2011 used multivariable logistic regression assess reasons surgeon hospital selection raceethnicity adjusting patient characteristics also assessed association reasons physician selection patients ratings surgeon hospitalreasons surgeon hospital selection ratings surgeon hospitalthe 500 participants represented response rate 478 participation rate 69 frequently reported reason surgeon selection referral another physician 78 frequently reported reason hospital selection part patients health plan 58 adjustment 79 87 black spanishspeaking hispanic women reported selecting surgeon based physicians referral vs 76 white women p 007 black hispanic patients less likely white patients report selecting surgeon based reputation adjusted rates 18 22 black hispanic women respectively vs 32 white women p 02 black hispanic women also less likely white women select hospital based reputation adjusted rates 7 15 vs 23 respectively p 003 women selected surgeon based reputation often rated care surgeon excellent adjusted odds ratio 221 95 ci 124393 reporting surgeon one surgeons available health plan less often reported excellent quality surgical care adjusted odds ratio 056 95 ci 034091compared white patients breast cancer minority patients less actively involved physician hospital selection relying physician referral health plans rather reputation interventions promote involvement surgeon hospital selection may potential addressing disparities related lowerquality care surgeons hospitals