Reliance on emergency departments (EDs) by economically disadvantaged people for initial cancer diagnosis in place of primary care and early diagnosis and treatment is 1 obvious plausible explanation for cancer disparities. Claims data from a safety net hospital for the years 2009–2010 were merged with hospital tumor registry data to compare hospitalizations for ED-associated initial cancer diagnoses to non–ED associated initial diagnoses. The proportion of initial cancer diagnoses associated with hospital admissions through the ED was relatively high (32%) for all safety net hospital patients, but disproportionately higher for African Americans and residents of the impoverished urban core. Use of the ED for initial diagnosis was associated with a 75% higher risk of stage 4 versus stage 1 cancer diagnosis, and a 176% higher risk of dying during the 2-year study period. Findings from this study of ED use within a safety net hospital documented profound disparities in cancer care and outcomes with major implications for monitoring disparities, Affordable Care Act impact, and safety net hospital utilization.
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:etsu-works-6337 |
| Date | 13 January 2016 |
| Creators | Livingood, William C., Smotherman, Carmen, Lukens-Bull, Katryne, Aldridge, Petra, Kraemer, Dale F., Wood, David L., Volpe, Carmine |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Source | ETSU Faculty Works |
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