RENAL SURGERY RATES FOR KIDNEY CANCER AT MINORITY SERVING HOSPITALS

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III (MP21)1 Apr 2020MP21-10 RENAL SURGERY RATES FOR KIDNEY CANCER AT MINORITY SERVING HOSPITALS Lina Posada Calderon*, Bashir Al Hussein Al Awamlh, Aleem I. Khan, Johannes Van der Mijn, Jonathan E. Shoag, Benjamin Taylor, and Douglas Scherr Lina Posada Calderon*Lina Posada Calderon* More articles by this author , Bashir Al Hussein Al AwamlhBashir Al Hussein Al Awamlh More articles by this author , Aleem I. KhanAleem I. Khan More articles by this author , Johannes Van der MijnJohannes Van der Mijn More articles by this author , Jonathan E. ShoagJonathan E. Shoag More articles by this author , Benjamin TaylorBenjamin Taylor More articles by this author , and Douglas ScherrDouglas Scherr More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000854.010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Minority serving hospitals (MSH) serve the highest percentage of black and Hispanic patients. Independent of patient and provider factors, treatment at MSH may result in lower quality of care. As black and Hispanic patients reportedly die more from kidney cancer, understanding the origin of the disparity is crucial to addressing it. Here, we assess whether kidney cancer care differs between minority-serving hospitals (MSH) and non-MSH. METHODS: Using the National Cancer Data Base (NCDB) from 2004 to 2015 we identified 240,527 adult patients diagnosed with non-metastatic kidney cancer. MSH were defined according to the proportion of Black and Hispanic patients treated at each facility. We used validated metrics for kidney cancer care, namely the odds of undergoing surgery for kidney cancer (partial or radical nephrectomy) and time from diagnosis to surgery, to measure the impact of treatment at MSH. RESULTS: 19,701 (8.2%) patients were treated at MSH and 220,826 (91.8%) at non-MSH of which 15,807 (80.2%) and 181,359 (82.1%) underwent renal surgery, respectively, p<0.001. In multivariable analysis, patients treated at MSH had lower odds of undergoing renal surgery as compared to patients treated at non-MSH, Odds Ratio (OR) 0.93, 95% CI 0.89 to 0.98; p=0.002. There was no difference in time from diagnosis to surgery, mean difference -0.47 days, 95% CI -1.38 to 0.44, p=0.307. In subset analysis, white and Hispanic patients had lower odds undergoing surgery when treated at MSH, OR 0.88, 95% CI 0.82 to 0.94 and OR 0.88, 95% CI 0.79 to 0.97, respectively. Further, when MSH were low-volume facilities, patients also had a decreased odds of undergoing surgery, OR 0.76, 95% CI 0.72 to 0.81; p<0.001. CONCLUSIONS: Treatment at MSH is associated with a lower likelihood of receiving surgery for kidney cancer. This effect is modified by race/ethnicity and by facility volume, which suggests a combination of health access, patient, and facility factors contribute to racial disparities in kidney cancer care. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e321-e322 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lina Posada Calderon* More articles by this author Bashir Al Hussein Al Awamlh More articles by this author Aleem I. Khan More articles by this author Johannes Van der Mijn More articles by this author Jonathan E. Shoag More articles by this author Benjamin Taylor More articles by this author Douglas Scherr More articles by this author Expand All Advertisement PDF downloadLoading ...