Racial/Ethnic Differences in Patients' Selection of Surgeons and Hospitals for Breast Cancer Surgery.

摘要: Importance Racial differences in breast cancer treatment may result part from the surgeons and hospitals whom patients receive their care. However, little is known about patients’ selection of hospitals. Objective To examine racial/ethnic how women selected for surgery. Design, Setting, Participants We surveyed 500 (222 non-Hispanic white, 142 black, 89 English-speaking Hispanic, 47 Spanish-speaking Hispanic) northern California registries with stage 0 to III diagnosed during 2010 through 2011. used multivariable logistic regression assess reasons surgeon hospital by race/ethnicity, adjusting other patient characteristics. also assessed association between physician ratings hospital. Main Outcomes Measures Reasons Results The participants represented a response rate 47.8% participation 69%. most frequently reported reason was referral another (78%); because it patient’s health plan (58%). After adjustment, 79% 87% black Hispanic selecting based on physician’s vs 76% white ( P  = .007). Black were less likely than report reputation (adjusted rates, 18% 22% women, respectively, 32% women;  = .02). select 7% 15% 23%, respectively;  = .003). Women who more often rated care as excellent odds ratio, 2.21; 95% CI, 1.24-3.93); those reporting one only available quality surgical 0.56; 0.34-0.91). Conclusions Relevance Compared cancer, minority actively involved selection, relying plans rather reputation. Interventions promote involvement have potential addressing disparities related lower-quality