Disparities in oncologic surgery.
Surgical oncology is one of the most frequently studied surgical specialties with regard to disparities in quality of care. There is variation in the care received according to nonclinical factors such as age, race and ethnicity, education, income, and even geographic region. Differences exist with regard to who gets treatment, what treatment is received, and the outcomes of those treatments. Although the existence of such disparities is no longer in doubt, the etiology is still being investigated. Ongoing research and quality improvement initiatives move beyond the mere description of existing disparities in one of three ways: (1) identifying and understanding the factors that lead to disparities; (2) advancing available methods to measure and track disparities; and (3) developing an approach to improvement. In this article, we start out by offering a framework to describe potential factors that lead to disparities, using examples from surgical oncology. We then describe the approaches to measuring and tracking disparities that are being used in research and quality improvement. Finally, we attempt to illustrate how all of these factors interact and offer some potential strategies to close the gap and alleviate disparities within the discipline.
Greenberg
Caprice C
CC
Center for Surgery and Public Health, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA. CCGREENBERG@PARTNERS.ORG
Weeks
Jane C
JC
Stain
Steven C
SC
D006302:Health Services Research / Q000379:methods; D054625:Healthcare Disparities; D006801:Humans; D008495:Medical Oncology / Q000331:legislation & jurisprudence / Q000592:standards*; D008913:Minority Groups; D054525:Minority Health; D009316:National Institutes of Health (U.S.); D016522:Oncology Service, Hospital / Q000592:standards*; D011787:Quality of Health Care; D018426:SEER Program; D013514:Surgical Procedures, Operative / Q000592:standards; D014481:United States