title: Minority Use of a National Cancer Institute-Designated Comprehensive Cancer Center and Non-specialty Hospitals in Two Florida Regions.
abstract: OBJECTIVE
  To examine cancer treatment disparities at a National Cancer Institute-designated comprehensive cancer center (NCI-CCC) and non-specialty hospitals.
  
  
  METHODS
  Florida hospital discharge datasets were used. ICD9-CM codes were used to define patients with female reproductive organ cancers (FROC), male reproductive organ cancers (MROC), and OTHER cancer diagnoses. A total of 7462 NCI-CCC patients and 21,875 non-specialty hospital patients were included in the statistical analysis. Data analysis was conducted in SAS 9.2.
  
  
  RESULTS
  Increases in age reduced the odds of receiving treatment at the NCI-CCC. Male patients were more likely than female patients to be treated at the NCI-CCC. Age-adjusted odds of African American and Hispanic out/inpatients being treated at the NCI-CCC were significantly lower than those of White out/inpatients. Only patients with workers' compensation, charity, or other insurance had higher odds of being treated at the NCI-CCC. The odds of minority patients receiving outpatient treatment at the NCI-CCC declined after 2005. The odds of receiving inpatient treatment at the NCI-CCC significantly increased after 2006.
  
  
  CONCLUSIONS
  More targeted outreach by the NCI-CCC is required. However, we expect the creation of local Accountable Care Organizations (ACOs) to reduce the numbers of minority and older patients at the NCI-CCC. Coordinated quality care at ACOs implies a potential for retaining the patient market share held by non-specialty hospitals and a potential for increased demand for ACO care by minority and older patients.
authors: Department of Health Policy and Management, College of Public Health, University of South Florida, 13201 Bruce B. Downs BLVD, MDC 56, Tampa, FL, 33612-3805, USA. dsultan@health.usf.edu.
authors: Dawood H
authors: DH
authors: Sultan
authors: Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs BLVD, MDC 56, Tampa, FL, 33612-3805, USA. jgishe@health.usf.edu.
authors: Jemal
authors: J
authors: Gishe
authors: Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs BLVD, MDC 56, Tampa, FL, 33612-3805, USA. ahancile@health.usf.edu.
authors: Angella
authors: A
authors: Hanciles
authors: Department of Health Policy and Management, College of Public Health, University of South Florida, 13201 Bruce B. Downs BLVD, MDC 56, Tampa, FL, 33612-3805, USA. comins.meg@gmail.com.
authors: Meg M
authors: MM
authors: Comins
authors: Louisiana Board of Regents, 1201 N. Third St., Suite 6-200, Baton Rouge, LA, 70802, USA. clairexula@gmail.com.
authors: Claire M
authors: CM
authors: Norris
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D054547:National Cancer Institute (U.S.); D009369:Neoplasms / Q000208:ethnology* / Q000628:therapy; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: African American; Comprehensive Cancer Center; Hispanic; Minority