Income disparities in needle biopsy patients prior to breast cancer surgery across physician peer groups.
Breast cancer
Breast cancer diagnosis
Breast cancer treatment
Breast surgery
Needle biopsy
Quality
Journal
Breast cancer (Tokyo, Japan)
ISSN: 1880-4233
Titre abrégé: Breast Cancer
Pays: Japan
ID NLM: 100888201
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
01
09
2019
accepted:
21
11
2019
pubmed:
4
12
2019
medline:
3
2
2021
entrez:
4
12
2019
Statut:
ppublish
Résumé
Evaluate income disparities in receipt of needle biopsy among Medicare beneficiaries and describe the magnitude of this variation across physician peer groups. The Surveillance, Epidemiology and End Results (SEER)-Medicare database was queried from 2007-2009. Physician peer groups were constructed. The magnitude of income disparities and the patient-level and physician peer group-level effects were assessed. Among 9770 patients, 65.4% received needle biopsy. Patients with low income (median area-level household income < $33K) were less likely to receive needle biopsy (58.5%) compared to patients with high income (≥ $50K) (68.6%; adjusted odds ratio 0.77; 95% confidence interval (CI) 0.65-0.91). Needle biopsy varied substantially across physician peer groups (interquartile range 43.4-81.9%). The magnitude of the disparity ranged from an odds ratio (OR) of 0.50 (95% CI 0.23-1.07) for low vs. high income patients to 1.27 (95% CI 0.60-2.68). The effect of being treated by a physician peer group that treated mostly low-income patients on receipt of needle biopsy was nearly three times the effect of being a low-income patient. Needle biopsy continues to be underused and disparities by income exist. The magnitude of this disparity varies substantially across physician peer groups, suggesting that further work is needed to improve quality and reduce inequities.
Identifiants
pubmed: 31792804
doi: 10.1007/s12282-019-01028-4
pii: 10.1007/s12282-019-01028-4
pmc: PMC7512133
mid: NIHMS1630384
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
381-388Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : NCI NIH HHS
ID : N02 PC015105
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA190017
Pays : United States
Organisme : NCI NIH HHS
ID : K07 CA151910
Pays : United States
Organisme : NIH HHS
ID : R01CA190017
Pays : United States
Organisme : NCI NIH HHS
ID : N01PC35136
Pays : United States
Organisme : NCI NIH HHS
ID : N01PC35139
Pays : United States
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