TY - JOUR
T1 - Availability of Healthcare Resources and Colorectal Cancer Outcomes Among Non-Hispanic White and Non-Hispanic Black Adults
AU - Akinyemiju, Tomi
AU - Waterbor, John W.
AU - Pisu, Maria
AU - Moore, Justin Xavier
AU - Altekruse, Sean F.
N1 - Publisher Copyright:
© 2015, Springer Science+Business Media New York.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - This study aims to examine if access to healthcare, measured through the availability of medical resources at the neighborhood level, influences colorectal cancer (CRC) stage, treatment and survival using the Surveillance Epidemiology and Ends Result (SEER) dataset (November 2012), linked with the 2004 Area Resource File. A cross-sectional study was conducted to determine the association between availability of healthcare resources and CRC outcomes among non-Hispanic Black (n = 9162) and non-Hispanic White patients (n = 97,264). CRC patients were identified using the SEER*Stat program, and individual socio-demographic, clinical, and county-level healthcare access variables were obtained for each patient. Among NH-W patients, residence in counties with lower number of oncology hospitals was associated with increased odds of late stage diagnosis (OR 1.09, 95 % CI 1.04–1.14), reduced odds of receiving surgery (OR 0.83, 95 % CI 0.74–0.92) and higher hazard rates (HR 1.09, 95 % CI 1.06–1.12). There were no significant associations among NH-B patients. Increased availability of healthcare resources improves CRC outcomes among NH-W patients. However, future studies are required to better understand healthcare utilization patterns in NH-B neighborhoods, and identify other important dimensions of healthcare access such as affordability, acceptability and accommodation.
AB - This study aims to examine if access to healthcare, measured through the availability of medical resources at the neighborhood level, influences colorectal cancer (CRC) stage, treatment and survival using the Surveillance Epidemiology and Ends Result (SEER) dataset (November 2012), linked with the 2004 Area Resource File. A cross-sectional study was conducted to determine the association between availability of healthcare resources and CRC outcomes among non-Hispanic Black (n = 9162) and non-Hispanic White patients (n = 97,264). CRC patients were identified using the SEER*Stat program, and individual socio-demographic, clinical, and county-level healthcare access variables were obtained for each patient. Among NH-W patients, residence in counties with lower number of oncology hospitals was associated with increased odds of late stage diagnosis (OR 1.09, 95 % CI 1.04–1.14), reduced odds of receiving surgery (OR 0.83, 95 % CI 0.74–0.92) and higher hazard rates (HR 1.09, 95 % CI 1.06–1.12). There were no significant associations among NH-B patients. Increased availability of healthcare resources improves CRC outcomes among NH-W patients. However, future studies are required to better understand healthcare utilization patterns in NH-B neighborhoods, and identify other important dimensions of healthcare access such as affordability, acceptability and accommodation.
KW - Cancer
KW - Colorectal cancer
KW - Disparities
KW - Healthcare access
KW - Residential area
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U2 - 10.1007/s10900-015-0096-z
DO - 10.1007/s10900-015-0096-z
M3 - Article
C2 - 26446012
AN - SCOPUS:84959575129
SN - 0094-5145
VL - 41
SP - 296
EP - 304
JO - Journal of Community Health
JF - Journal of Community Health
IS - 2
ER -