Abstract PO-094: Socioeconomic status and utilization of cancer surgeries in the United States, Canada, and Australia
Notice bibliographique
Résumé
Abstract Background: Few studies have compared surgical oncology utilization between countries or how rates may differ according to patients’ socioeconomic status. This study aimed to compare the utilization rates of three organ resection surgeries predominantly indicated for the treatment of cancer in three jurisdictions in the US, Canada, and Australia, and compare surgical utilization rates between residents of lower- and higher-income neighborhoods. Methods: We used population-based administrative data to identify all adults aged ≥18 years hospitalized for pancreatectomy (PX), radical prostatectomy (RP) and nephrectomy (NX) between 2011-2016 (New York, USA), 2011-2018 (Ontario, Canada), and 2013-2018 (New South Wales, Australia). We linked each patient’s zip-code of residence to 2016 census data to ascertain neighborhood income. We compared utilization rates for each procedure in each jurisdiction in aggregate and by neighborhood income quintile. The primary outcomes were: 1) each jurisdictions’ per-capita overall, age-, and sex-standardized utilization rates for each procedure; and 2) utilization rates amongst residents of lower- and higher-income neighborhoods. Results: Sociodemographics were generally similar across jurisdictions, though patients in New South Wales were slightly older for all procedures. Hospitals in New York were significantly more likely to perform each of the three procedures compared to Ontario and New South Wales (all P<0.001), while New York and New South Wales tended to have more low-volume hospitals relative to Ontario. Overall utilization rate was highest in New York for NX (28.93 procedures per-100,000 per-year) while New South Wales had highest utilization of PX and RP (6.94 and 94.37, respectively); overall utilization of all three procedures was lowest in Ontario (PX 6.18; RP 49.24; NX 21.40; all P<.001). Utilization of PX and NX was significantly higher for men than women in all jurisdictions (all P<0.05). Utilization of all three procedures increased until age 70-79, before declining at age ≥80 (all P<0.001). With the exception of NX in Ontario, residents of lowest income neighbourhoods (quintile 1 [Q1]) had lower surgical utilization rates than residents of highest income neighbourhoods (quintile 5 [Q5]). The Q5-Q1 utilization rate difference was largest in New South Wales for PX and RP (PX +4.65 procedures per-100,000 per-year for Q5 vs Q1; RP +73.46; NX +6.23), largest in New York for NX and smallest for RP (PX +3.05; RP +19.70; NX +8.43) and smallest in Ontario for PX and NX (PX +1.15; RP +27.94; NX -1.10) (all P<0.05). Conclusions: Utilization rates of PX, RP, and NX were significantly higher in New York and New South Wales than in Ontario. Rich-poor surgical utilization differences were significantly larger in New York and New South Wales and significantly smaller in Ontario. These findings suggest that income-based disparities are larger in jurisdictions in the US and Australia and smaller in Canada, and highlight the possible trade-offs of equity and access in healthcare systems of different countries. Citation Format: Hilary Pang, Kelsey Chalmers, Bruce Landon, Adam Elshaug, John Matelski, Vicki Ling, Monika K. Krzyzanowska, Girish Kulkarni, Bradley A. Erickson, Peter Cram. Socioeconomic status and utilization of cancer surgeries in the United States, Canada, and Australia [abstract]. In: Proceedings of the AACR Virtual Special Conference on Artificial Intelligence, Diagnosis, and Imaging; 2021 Jan 13-14. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(5_Suppl):Abstract nr PO-094.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».