区域脆弱性和治疗中差异对于患有转移性细胞癌的患者
Syed N Rahman1, Jessica B Long2, Sarah J Westvold2
1Department of Urology, Yale School of Medicine, New Haven, Connecticut.
JAMA network open
|April 30, 2024
概括
种族,性别和收入等个人因素,而不是区域级的社会脆弱性,影响了转移性细胞癌 (mRCC) 治疗. 在mRCC治疗中的种族差异集中在社会脆弱的地区.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
背景情况:
- 区域层面的社会人口学劣势可能导致转移性细胞癌 (mRCC) 治疗中的种族和民族差异.
- 之前的研究还没有研究区级社会脆弱性与mRCC治疗差异之间的关联.
研究的目的:
- 评估区域级社会脆弱性措施与美国医疗保险受益者与mRCC治疗中的种族和种族差异之间的关联.
- 确定影响mRCC患者接受全身治疗的因素.
主要方法:
- 65岁以上的医疗保险受益人被诊断患有mRCC (2015-2019) 的回顾性队列研究.
- 利用了县级和邮政编码级的弱势,脆弱,贫困和隔离的措施.
- 分析了患者层面的因素,包括年龄,种族/民族,性别,并发症和低收入补贴 (LIS) 状态.
- 进行了多变量回归分析,以评估与全身治疗接收的关联.
主要成果:
- 个人层面的因素,如女性性别和LIS资格,与减少系统治疗接收有关.
- 没有县级或邮政编码级的社会脆弱性,贫困或隔离措施与整体待遇差异直接相关.
- 对待的种族和民族差异主要在社会上最脆弱的地区观察到.
结论:
- 个体患者的特征,而不是区域级的社会脆弱性,是mRCC治疗差异的主要驱动因素.
- 在mRCC治疗中的种族和民族差异似乎集中在社会脆弱的人群中.
- 针对社会脆弱地区的有针对性的干预措施可能对于减少mRCC治疗中的种族和民族差异至关重要.
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