Impact of Healthcare Access Disparities on Initial Diagnosis of Breast Cancer in the Emergency Department

Abstract

Breast cancer continues to be the second leading cause of cancer deaths in women in the United States. This is more noticeable in communities with pronounced healthcare disparities. The aim of this study was to investigate the different demographics that might play a role in the detection of breast cancer in a county hospital emergency department (ED). A retrospective study was conducted of female patients diagnosed with breast cancer over a five-year period (1/1/2015 to 12/31/2018). Patients with breast cancer as the primary or secondary diagnosis were identified. This study shows that 66 (73.3%) women diagnosed in the ED were Hispanic or African American. There was a significant delay (a median of 461 days) in the time between the diagnosis of suspected breast cancer in the ED to their follow-up visit with definitive diagnosis in a primary care clinic. These findings suggest that women with a suspected breast cancer diagnosis who are seen in a safety net hospital and have Medicaid funding may have significant delays before final diagnosis is made. Patient demographics could have an impact on the patients' access to screening and regular healthcare visits, hindering an early breast cancer diagnosis by a primary care provider.

Exacerbation of Inequities in Use of Diagnostic Radiology During the Early Stages of Reopening After COVID-19

“…Pre-COVID-19, Hispanic ethnicity had been identified in several studies to be significantly associated with delays in diagnostic imaging [ 13 , 22 ]. However, more conflicting results have been seen with Asian patients and diagnostic radiology examination follow-ups [ 19 ].…”

Impact of Insurance Type on Access to Pediatric Surgical Care

“…However, future studies should investigate whether such inequities exist in other healthcare contexts or practice settings, as our findings differ from what has been documented in the literature. 1–16…”

“…[1][2][3][4][5] It is well known that adult patients with public health insurance, such as Medicaid, are more likely to experience delays in treatment compared with those with private insurance. [6][7][8][9][10][11][12][13] Studies also suggest that those with public insurance may experience worse postoperative outcomes, lower provider follow-up rates, longer recovery times, longer hospital stays, and higher total cost. [14][15][16] However, a dearth of pediatric literature explores how insurance type impacts children's access to surgical care.…”

Overcoming Disparities in Cancer: A Need for Meaningful Reform for Hispanic and Latino Cancer Survivors

“…There are vast documented disparities in clinical and patient-reported outcomes (PROs) across most malignancies, with overwhelming evidence suggesting that HLs are at a critical disadvantage. Hispanics and Latinos, specifically, present with more advanced disease and have a poorer prognosis for several different cancers relative to NHWs [10][11][12][13][14][15][16] .…”