在低收入服务医院的多个癌症部位的生存率差异
Naveen V Manisundaram1,2, Chung-Yuan Hu1, Joshua N Herb3
1Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Annals of surgical oncology
|May 31, 2025
概括
服务于低收入患者的医院的癌症存活率明显更差. 收入差异和医院类型加剧了这些差异,影响了患者的治疗结果.
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:
- 健康的社会决定因素显著影响癌症发病率,诊断和治疗.
- 影响患者结果的设施级因素往往被忽视.
- 这项研究调查了在服务于低收入人口的医院治疗的癌症患者的生存结果.
研究的目的:
- 为了确定服务于最低收入患者的医院是否表现出较差的整体生存率.
- 分析医院收入水平对主要癌症类型患者存活率的影响.
- 了解收入不平等和医疗保健设施类型对癌症结果差异的贡献.
主要方法:
- 利用国家癌症数据库识别被诊断为非转移性结肠直肠,乳腺,胃和胰腺癌的患者 (2010-2019).
- 通过住宅邮政编码估计的患者中位收入和按医院汇总的计算线性平均得分 (LMS).
- 医院根据平均患者LMS分为四分之一,比较收入最低的医院 (LIH) 与收入最高的医院 (HIH).
主要成果:
- 包括833,874名患者在结肠直肠,乳腺,胃和胰腺癌类型.
- 在所有分析的癌症中,五年整体存活率在LIH与HIH相比较低 (例如,结肠直肠癌:67.6%与73.6%,乳腺:81.9%与89.5%).
- 在医院收入四分之一和存活率之间观察到剂量依赖的关系,在每个四分之一内,更高的收入与死亡风险降低有关.
结论:
- 在LIH治疗主要癌症的患者,与HIH治疗患者相比,生存结果更差.
- 收入不平等显然有助于癌症医疗保健结果的差异.
- 患者接受护理的机构加剧了现有的医疗保健结果差异.
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