Disparities in outcomes for pediatric cancer patients treated in Hawai'i: comparing Hawai'i residents to children referred from the Pacific Islands.
This article examines whether pediatric cancer patients referred to Hawai'i from the Pacific Islands had poorer outcomes than Hawai'i residents treated at the same hospital. For children admitted from 1981 to 2002, we obtained data on patient demographics and outcomes from a review of medical charts and physician case reviews. We found that pediatric cancer patients referred from the Pacific Islands for treatment in Hawai'i had a higher relative risk of death, of not receiving treatment in a timely manner, of not completing treatment, and of being lost to follow-up than pediatric cancer patients that were residents of Hawai'i. The higher risk of poor outcomes for pediatric cancer patients referred from the Pacific Islands can be addressed by improving the health care systems in both the Pacific Islands and in Hawai'i.
Untalan
Faye
F
Department of Public Health Sciences and Epidemiology (DPHSE), John A. Burns School of Medicine (JABSOM), University of Hawai'i, USA. funtalan@hawaii.edu
Woodruff
Kelley
K
Hardy
Charles
C
Liao
Mira
M
Krupitsky
Dmitry
D
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008485:Medical Audit; D008495:Medical Oncology / Q000592:standards*; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000208:ethnology* / Q000628:therapy*; D016522:Oncology Service, Hospital / Q000592:standards*; D010139:Pacific Islands / Q000208:ethnology; D010372:Pediatrics / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards*; D018570:Risk Assessment; D012307:Risk Factors; D012935:Social Justice; D012959:Socioeconomic Factors; D013997:Time Factors; D016896:Treatment Outcome