Abstract No. 697 New York State demographic trends in radioembolization

Abstract

Radioembolization (RE) is increasingly being performed in the treatment of hepatocellular carcinoma and liver metastases. This study examines the demographic trends associated with RE performed in New York State. The New York Statewide Planning and Research Cooperative System, which covers all admissions and ambulatory care encounters in New York State, was queried over the period from 2006 to 2014 for encounters involving patients who were diagnosed with a hepatic tumor and where RE was performed. Encounters were divided by year into 3 categories: 2006-2008, 2009-2011, and 2012-2014. Patient demographic information was supplemented by facility information from the American Hospital Association was compared using Mann–Whitney U and chi-square tests. A total of 2,211 encounters involving RE were identified, occurring at a total of 22 facilities in New York State. The number of facilities performing RE increased from 3 in the earliest time period to 22 in the latest. Similarly, the number of RE's increased from 225 to 1,516, representing a 556% increase. The proportion of African-Americans who underwent RE increased from 5% to 14% (p<0.01). The proportion of RE's performed at major teaching hospitals decreased from 100% to 80% (p<0.01). Over the period from 2006 to 2014, the quantity of RE's performed has increased drastically. During this same period, there has been a significant expansion in the proportion of REs performed by non-major academic centers. This expansion has been paralleled by an increase in the proportion of African-Americans undergoing RE.Tabled 1New York State Demographic Trends in Radioembolization[2006,2009)[2009,2012)[2012,2015)Number of Procedures2254701516Number of Patients1773561129Number of Facilities31222Number of Surgeons154581Patient Race (%) Caucasian182 (0.80)315 (0.67)918 (0.60) African American12 (0.05)67 (0.14)212 (0.14) Asian17 (0.08)33 (0.07)86 (0.06) Other14 (0.06)55 (0.12)300 (0.20)Ethnicity (%) Non-Hispanic218 (0.97)434 (0.92)1417 (0.93) Hispanic7 (0.03)36 (0.08)86 (0.06)Patient Age (SD)62.4 (12.10)61.2 (11.51)64.03 (11.06)Patient Primary Insurance (%) Private Insurance60 (0.27)266 (0.57)742 (0.49) Medicaid2 (0.01)13 (0.03)46 (0.03) Medicare69 (0.31)184 (0.39)711 (0.47) Other/Unknown90 (0.40)6 (0.01)12 (0.01)Average Income based on Patient County (sd)70031.25 (8255.35)68441.16 (12405.53)69853.86 (13233.23)Charlson Comorbidity Index (sd)4.12 (2.01)4.26 (2.09)3.89 (2.04)Facility Setting (%) Urban225 (1.00)470 (1.00)1466 (0.97) Rural0 (0.00)0 (0.00)50 (0.03) In NYC138 (0.61)336 (0.71)1073 (0.71)Teaching Affiliation (%) Major225 (1.00)416 (0.89)1219 (0.804090) Minor0 (0.00)52 (0.11)227 (0.149736) Non-Teaching0 (0.00)2 (0.00)70 (0.05) Open table in a new tab