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Effect of Hospital Safety Net Burden on Survival for Patients With Sinonasal Squamous Cell Carcinoma.
- Source :
-
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2023 Mar; Vol. 168 (3), pp. 413-421. Date of Electronic Publication: 2023 Jan 28. - Publication Year :
- 2023
-
Abstract
- Objective: To examine factors associated with hospital safety net burden and its impact on survival for patients with sinonasal squamous cell carcinoma (SNSCC).<br />Study Design: Retrospective database study.<br />Setting: National Cancer Database from 2004 to 2016.<br />Methods: SNSCC cases were identified in the National Cancer Database. Hospital safety net burden was defined by percentage of uninsured/Medicaid patients treated, namely ≤25% for low-burden hospitals, 26% to 75% for medium-burden hospitals, and >75% for high-burden hospitals (HBHs). Univariate and multivariate analyses were used to investigate patient demographics, clinical characteristics, and overall survival.<br />Results: An overall 6556 SNSCC cases were identified, with 1807 (27.6%) patients treated at low-burden hospitals, 3314 (50.5%) at medium-burden hospitals, and 1435 (21.9%) at HBHs. On multivariate analysis, Black race (odds ratio [OR], 1.39; 95% CI, 1.028-1.868), maxillary sinus primary site (OR, 1.31; 95% CI, 1.036-1.643), treatment at an academic/research program (OR, 20.63; 95% CI, 8.868-47.980), and treatment at a higher-volume facility (P < .001) resulted in increased odds of being treated at HBHs. Patients with grade III/IV tumor (OR, 0.70; 95% CI, 0.513-0.949), higher income (P < .05), or treatment modalities other than surgery alone (P < .05) had lower odds. Survival analysis showed that hospital safety net burden status was not significantly associated with overall survival (log-rank P = .727).<br />Conclusion: In patients with SNSCC, certain clinicopathologic factors, including Black race, lower income, treatment at an academic/research program, and treatment at facilities in the West region, were associated with treatment at HBHs. Hospital safety net burden status was not associated with differences in overall survival.<br /> (© 2022 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)
Details
- Language :
- English
- ISSN :
- 1097-6817
- Volume :
- 168
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 35608906
- Full Text :
- https://doi.org/10.1177/01945998221099819