Study Identifies Racial and Ethnic Differences in Selecting Surgeons, Hospitals for Breast Cancer Care
Black and Hispanic women with breast cancer were less likely to choose their surgeon and the hospital for treatment based on reputation compared with white women, according to researchers. These findings suggest minority patients may rely more on physician referrals and health plans in those decisions, according to a study published by Freedman et al in JAMA Oncology.
Study Details
Racial and ethnic disparities in the use, quality, and delivery of medical care have been well described. However, data are limited with regard to how women select surgeons and hospitals for cancer treatment and whether there are racial and ethnic differences in those decisions.
Rachel A. Freedman, MD, MPH, of the Dana-Farber Cancer Institute, and colleagues surveyed 500 women in northern California (222 non-Hispanic white, 142 non-Hispanic black, 89 English-speaking Hispanic, and 47 Spanish-speaking Hispanic) to examine racial and ethnic differences when women selected surgeons and hospitals for breast cancer care.
The authors found referral by another physician to be the most frequently reported reason for surgeon selection (78%), and a hospital being part of a patient's health plan was the most common reason for hospital selection (58%).
Black and Hispanic patients were less likely than white patients to report selecting their surgeon based on reputation (18% and 22% for black and Hispanic women, respectively, vs 32% of white women). Black and Hispanic women also were less likely than white women to select their hospital based on reputation (7% and 15% vs 23%, respectively).
Possible Causes
The authors noted a high proportion of women were insured by Kaiser Permanente, which could explain why a large number of women reported their health plan influenced their selection.
“Most women relied on referrals from their physicians for selecting surgeons, particularly black women and Spanish-speaking Hispanic women. In addition, minority patients were less likely to report reputation as an important component of their decisions about surgeons and hospitals and were more likely to select a hospital because it was part of their health plan. These findings suggest less-active involvement of minority patients with regard to selecting physicians and hospitals for their care,” the study concluded.
Dr. Freedman is the corresponding author of the JAMA Oncology article.
The study was sponsored by the Komen for the Cure Foundation.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
