Racial/Ethnic Disparities in Use of High-Quality Hospitals Among Thyroid Cancer Patients

Abstract

This study examined racial/ethnic differences in the use of high-quality hospitals among thyroid cancer patients. The study included adult patients diagnosed between 2004 and 2015 identified in the California Cancer Registry linked with hospital discharge records. Hospital quality was defined using a composite thyroid cancer-specific hospital quality score. Black (risk ratio [RR] 0.75, 95% CI 0.70–0.80), Hispanic (RR 0.73, 95% CI 0.71–0.75), and Asian/Pacific Islander patients (RR 0.86, 95% CI 0.84–0.89) were less likely to be treated in high-quality hospitals than non-Hispanic White patients. This disparity persisted after adjusting for insurance status and socioeconomic status.

Keywords:

• Thyroid cancer
• health status disparities
• minority health
• quality of care
• high-volume hospitals

Declaration of interest

The authors report no conflict of interest. This work was conducted with support from a Stanford Cancer Institute – 2018 Cancer Innovation Award. The ideas and opinions expressed herein are those of the author(s) and do not necessarily reflect the opinions of the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors.

Additional information

Funding

The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP006344; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute, Cancer Registry of Greater California.