Access to bone marrow transplantation for leukemia and lymphoma: The role of sociodemographic factors
Access to bone marrow transplantation for leukemia and lymphoma: The role of sociodemographic factors
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DOI：
10.1200/jco.1997.15.7.2644
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发表时间：
1997-07-01
影响因子：
45.3
通讯作者：
Schulman, KA
中科院分区：
文献类型：
--
作者：
Mitchell, JM;Meehan, KR;Schulman, KA
目的：近年来，骨髓移植（BMT）（一种用于多种形式的癌症的复杂、昂贵的治疗）的使用显著增加。竞争日益激烈的医疗保健市场引起了对患者获得昂贵的医疗程序（例如BMT）的关注。我们试图评估患者获得BMT以治疗白血病和淋巴瘤。我们分析了来自四个州的住院患者出院数据，（加州、马里兰州、马萨诸塞州、和纽约）两年（1988年和1991年），以检查骨髓移植用于白血病或淋巴瘤患者是否因社会人口特征和保险范围而异，我们开发了一种排序算法，将出院数据折叠成患者级别的记录。我们用逻辑回归分析按疾病类型（白血病或淋巴瘤）分层的接受BMT的几率。结果：在控制其他因素后，黑人白血病患者接受BMT的可能性是白人的51%至53%，而黑人淋巴瘤患者接受BMT的可能性是白人的34%至45%（P < 0.05）。
Purpose: Use of bone marrow transplantation (BMT), a complex, costly treatment for many forms of cancers, has increased significantly in recent years, The increasingly competitive health care marketplace raises concerns about patient access to costly medical procedures such as BMT, We attempted to evaluate patient access to BMT for the treatment of leukemias and lymphomas,Methods: We analyzed inpatient hospital discharge data from four stares (California, Maryland, Massachusetts, and New York) for 2 years (1988 and 1991) to examine whether the use of BMT for patients with either leukemia or lymphoma varies by sociodemographic characteristics and insurance coverage, We developed a sorting algorithm to collapse the discharge data into patient level records. We used logistic regression to analyze the odds of receiving a BMT stratified by disease type (leukemia or lymphoma),Results: After controlling for other factors, black patient with leukemia are 51% to 53% as likely as whites, while black patients with lymphoma are 34% to 45% as likely as white patients to undergo a BMT (P