Racial Disparities in Neuro-Oncologic Care Worsen

Hispanics and blacks less likely to have access to high-quality care
By A. Agrawal, PhD
HealthDay Reporter

THURSDAY, March 18 (HealthDay News) -- Access to high-quality neuro-oncologic care has worsened over time for Hispanics and blacks in the United States, even though access has improved overall, according to research in the March issue of the Archives of Surgery.

Debraj Mukherjee, M.D., and colleagues from the Johns Hopkins School of Medicine in Baltimore, Md., retrospectively examined the role of race, ethnicity, and social status on admission to high-volume hospitals (a measure of high-quality care) in the United States using data from 76,436 adults who underwent craniotomy for tumor biopsy or resection from 1988 to 2005.

The researchers found that 33.3 percent of patients were admitted to high-volume hospitals. Although overall access to high-volume hospitals improved over time, access worsened with time for Hispanics (odds ratio, 0.49) and blacks (odds ratio, 0.62). Access improved with time (odds ratio, 1.11), greater neurosurgeon density (odds ratio, 1.66), and greater household income (odds ratio, 1.71). Access worsened with increasing age (odds ratio, 0.34 per year), greater poverty (odds ratio, 0.57), in Hispanics (odds ratio, 0.68), and with greater comorbidities (odds ratio, 0.96 per point increase in the Charlson Comorbidity Index).

"African-Americans and Hispanics have disproportionately worse access to high-quality neuro-oncologic care over time compared with whites," Mukherjee and colleagues conclude. "Higher countywide median household income and decreased countywide poverty rate were associated with better access to high-volume hospitals, implicating socioeconomic factors in predicting admission to high-quality centers."

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