Impact of Healthcare Access Disparities on Initial Diagnosis of Breast Cancer in the Emergency Department
Impact of Healthcare Access Disparities on Initial Diagnosis of Breast Cancer in the Emergency Department
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DOI：
10.7759/cureus.10027
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发表时间：
2020-08-25
影响因子：
1.2
通讯作者：
Neeki, Michael M.
中科院分区：
文献类型：
--
作者：
Yee, Allison M.;Mazumder, Preeanka K.;Neeki, Michael M.
乳腺癌仍然是美国妇女癌症死亡的第二大原因。这在医疗保健差距明显的社区更为明显。本研究的目的是调查可能在县医院急诊科（艾德）检测乳腺癌中发挥作用的不同人口统计学特征。对五年期间（2015年1月1日至2018年12月31日）诊断为乳腺癌的女性患者进行了回顾性研究。以乳腺癌为主要或次要诊断的患者被确定。这项研究表明，66名（73.3%）在艾德诊断的妇女是西班牙裔或非洲裔美国人。在艾德的疑似乳腺癌诊断与在初级保健诊所的确诊随访之间存在显著延迟（中位数为461天），这些发现表明，在安全网医院就诊并获得医疗补助资金的疑似乳腺癌诊断女性在最终诊断之前可能存在显著延迟。患者人口统计学可能会影响患者接受筛查和定期医疗保健访问，阻碍初级保健提供者对乳腺癌的早期诊断。
Breast cancer continues to be the second leading cause of cancer deaths in women in the United States. This is more noticeable in communities with pronounced healthcare disparities. The aim of this study was to investigate the different demographics that might play a role in the detection of breast cancer in a county hospital emergency department (ED).A retrospective study was conducted of female patients diagnosed with breast cancer over a five-year period (1/1/2015 to 12/31/2018). Patients with breast cancer as the primary or secondary diagnosis were identified.This study shows that 66 (73.3%) women diagnosed in the ED were Hispanic or African American. There was a significant delay (a median of 461 days) in the time between the diagnosis of suspected breast cancer in the ED to their follow-up visit with definitive diagnosis in a primary care clinic.These findings suggest that women with a suspected breast cancer diagnosis who are seen in a safety net hospital and have Medicaid funding may have significant delays before final diagnosis is made. Patient demographics could have an impact on the patients' access to screening and regular healthcare visits, hindering an early breast cancer diagnosis by a primary care provider.