title: Impact of race and ethnicity on outcomes and health care utilization after allogeneic hematopoietic cell transplantation.
abstract: Disparities in outcomes after hematopoietic cell transplant (HCT) are reported mostly by registry studies. We examined the association of self-reported race and ethnicity with outcomes and health care utilization after allogeneic HCT in a single center study. Clinical and socioeconomic data of 296 adult patients who underwent allogeneic HCT from November 2003 to October 2012 were analyzed. Survival was compared between non-Hispanic Whites (NHW) and minority patients using Cox proportional hazards regression. Some 73% of patients were NHW and 27% were racial/ethnic minority patients. More minority patients were younger and had lower socioeconomic status. Both unadjusted and adjusted overall and progression-free survival were comparable between the two groups. High risk disease, poor performance score and Medicare/Tricare were significant predictors of mortality. Health care utilization was comparable between the two groups. Homogeneity of medical care for allogeneic HCT may help overcome racial/ethnic disparities, but not those due to patients' primary insurance.
authors.affiliation: Mayo Clinic in Arizona , Phoenix, AZ , USA.
authors.forename: Nandita
authors.initials: N
authors.lastname: Khera
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Chang
authors.forename: James
authors.initials: J
authors.lastname: Slack
authors.forename: Veena
authors.initials: V
authors.lastname: Fauble
authors.forename: Jose F
authors.initials: JF
authors.lastname: Leis
authors.forename: Pierre
authors.initials: P
authors.lastname: Noel
authors.forename: Lisa
authors.initials: L
authors.lastname: Sproat
authors.forename: Jeanne
authors.initials: J
authors.lastname: Palmer
authors.forename: Roberta
authors.initials: R
authors.lastname: Adams
authors.forename: Tom
authors.initials: T
authors.lastname: Fitch
authors.forename: Donald
authors.initials: D
authors.lastname: Northfelt
authors.forename: Mignonne
authors.initials: M
authors.lastname: Guy
authors.forename: Jon
authors.initials: J
authors.lastname: Tilburt
authors.forename: Joseph
authors.initials: J
authors.lastname: Mikhael
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data*; D018380:Hematopoietic Stem Cell Transplantation / Q000208:ethnology / Q000379:methods / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D007938:Leukemia / Q000208:ethnology / Q000628:therapy; D008223:Lymphoma / Q000208:ethnology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000208:ethnology / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012959:Socioeconomic Factors; D014184:Transplantation, Homologous; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Hematopoietic cell transplant; disparities; health care utilization; race/ethnicity