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Racial/Ethnic Disparities in Time to a Breast Cancer Diagnosis

The Mediating Effects of Health Care Facility Factors

Datos Bibliográficos

ID9103566
AutoresYamile Molina (0000-0001-8742-5658, Chicago Department of Public Health, autor de correspondencia), Abigail Silva (0000-0002-1112-1209, Edward Hines, Jr. VA Hospital), Garth H Rauscher (0000-0003-0374-944X, University of Illinois Chicago, autor de correspondencia)
Año2015
Volumen53
Número10
Páginas872-878
Fecha de publicación2015-10-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000417
PMID26366519
OpenAlexW2429819873
IdiomaEN
Citas recibidas8
Referencias citadas41

BACKGROUND: Racial/ethnic disparities exist along the breast cancer continuum, including time to a diagnosis. Previous research has largely focused on patient-level factors, and less is known about the role that health care facilities may play in delayed breast cancer care. OBJECTIVES: We examined racial/ethnic disparities in delayed diagnosis for breast cancer in the Breast Cancer Care in Chicago Study and estimated the potential mediating effects of facility factors. RESEARCH DESIGN AND SUBJECTS: Breast cancer patients (N=606) contributed interview and medical record data as part of a population-based study. MEASURES: Race/ethnicity was self-reported at interview. Diagnostic delay was defined as an excess of 60 days between medical presentation and a definitive diagnosis. Facility factors included the facility of medical presentation with respect to: (1) accreditation through the National Consortium of Breast Centers; (2) certification as a Breast Imaging Center of Excellence through the American College of Radiology; and (3) status as a disproportionate share hospital through the state of Illinois as well as the number of facilities used between presentation and diagnosis. RESULTS: Relative to non-Hispanic whites, minorities were more likely to experience a diagnostic delay, present at a nonaccredited facility and at a disproportionate share hospital, and involve multiple facilities in their diagnosis. Together, facility factors accounted for 43% of the disparity in diagnostic delay (P<0.0001). CONCLUSIONS: Initial presentation of breast cancer at higher resourced facilities can reduce diagnostic delays. Disparities in delay are partly due to a disproportionate presentation at lower resourced facilities by minorities

Breast cancer · Cancer · Environmental health · Ethnic group · Excellence · Family medicine · Health care · Health equity · Medical record · Obstetrics · Pathology · Population · Presentation (obstetrics) · Public health · Digital Radiography and Breast Imaging · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Radiology practices and education · Gerontology

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Obras citantes distintas8
Citas por año1
Intervalo de citas2018 - 2025 (8)
Velocidad de citaciónrecent
Altamente citadoNo
Tipos de citaNeutras: 8
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