Racial/Ethnic Disparities in Lung Cancer Surgery Outcomes in the USA.

Area of Science:

• Oncology
• Health Services Research
• Health Disparities

Background:

• Limited data exist on racial/ethnic disparities in lung cancer care, especially concerning healthcare utilization patterns like emergency department (ED) visits and outpatient follow-ups.
• Assessing these disparities is crucial for improving equitable patient care.

Purpose of the Study:

• To investigate racial/ethnic disparities in healthcare utilization and clinical outcomes among patients undergoing pulmonary resections for lung cancer.
• To leverage a large, multicenter, and diverse integrated health system for comprehensive analysis.

Main Methods:

• A cohort of 645 patients undergoing pulmonary resections for lung cancer between January 2016 and December 2020 was analyzed.
• Outcomes including length of stay, 30-day ED return, readmission, outpatient appointments, and mortality were compared across racial/ethnic groups.
• Multivariable models adjusted for demographic, clinical, and socioeconomic factors.

Main Results:

• While clinical outcomes showed parity across groups, bivariate analysis revealed differences in 30-day surgical outpatient appointments.
• Multivariable analysis indicated Asian patients had lower odds of 30-day ED return (aOR 0.51; 95% CI 0.27-0.98).
• Medicaid insurance was associated with higher odds of 30-day ED return (aOR 3.29; 95% CI 1.26-8.59).

Conclusions:

• Despite similar clinical outcomes, patient encounter-related differences persist within the healthcare system.
• Tracking healthcare utilization disparities alongside clinical outcomes is essential for a comprehensive understanding of racial/ethnic inequities in lung cancer care.