黑人结肠癌患者的医院认证状况和治疗差异
Kelley Chan1,2, Bryan E Palis1, Joseph H Cotler1
1American College of Surgeons Cancer Programs, Chicago, Illinois.
JAMA network open
|August 21, 2024
概括
癌症委员会 (CoC) 认可的医院的治疗改善了符合指南的护理,并降低了黑人结肠癌患者的死亡率. 这凸显了认证在减少癌症护理差异方面的重要性.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 癌症的差异 在癌症的差异中
背景情况:
- 医院因素影响黑人患者的癌症治疗差异.
- 关于医院认证对黑人患者癌症护理的影响的数据有限.
- 癌症委员会 (CoC) 认证是护理质量的潜在标志物.
研究的目的:
- 评估CoC医院认证与符合指南的护理之间的关联.
- 评估CoC认证对结肠癌黑人患者死亡率的影响.
主要方法:
- 基于人口的队列研究,利用国家癌症登记程序 (2018-2020年).
- 包括17,249名18岁以上的非西班牙裔黑人患者,患有结肠癌.
- 基于使用后勤和Cox回归模型的CoC认证状态的比较结果 (指导方针一致的护理,3年癌症特异性死亡率).
主要成果:
- 在CoC认可医院的患者 (74.0%) 接受指导方针一致的淋巴切除术 (AOR,1.89) 和化疗 (AOR,2.31) 的几率更高.
- 在CoC认可的医院接受治疗与I-III期手术患者 (AHR,0.87) 和III期化学疗法合格患者 (AHR,0.75) 的癌症特异性死亡率较低有关.
- 两组平均年龄或性别分布没有显著差异.
结论:
- CoC认可的医院与改善的指导方针一致的护理和减少结肠癌黑人患者的死亡率有关.
- 医院认证地位是缓解癌症治疗差异的一个重要因素.
- 在CoC认可的机构扩大获得高质量的护理的机会,可能会减少受服务不足的人群癌症结果的差异.
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