Abstract
Background and objectives: This study aimed to determine if age, race, region, insurance, and comorbidities affect the type of breast reconstruction that patients receive. Materials and methods: This analysis used the Florida Inpatient Discharge Dataset from 1 January 2013 to 30 September 2017, which contains deidentified patient-level administrative data from all acute care hospitals in the state of Florida. We included female patients, diagnosed with breast cancer, who underwent mastectomy and a subsequent breast reconstruction. We performed an χ2 test and logistic regression in this analysis. Results: On the multivariable analysis, we found that age, race, patient region, insurance payer, and Elixhauser score were all variables that significantly affected the type of reconstruction that patients received. Our results show that African American (odds ratio (OR): 0.68, 95%CI: 0.58–0.78, p < 0.001) and Hispanic or Latino (OR: 0.82, 95%CI: 0.72–0.93, p = 0.003) patients have significantly lower odds of receiving implant reconstruction when compared to white patients. Patients with Medicare (OR: 1.57, 95%CI: 1.33–1.86, p < 0.001) had significantly higher odds and patients with Medicaid (OR: 0.61, 95%CI: 0.51–0.74, p < 0.001) had significantly lower odds of getting autologous reconstruction when compared to patients with commercial insurance. Conclusions: Our study demonstrated that, in the state of Florida over the past years, variables, such as race, region, insurance, and comorbidities, play an important role in choosing the reconstruction modality. More efforts are needed to eradicate disparities and give all patients, despite their race, insurance payer, or region, equal access to health care.
Highlights
The United States has 3.5 million breast cancer survivors [1]
There were a higher number of patients with no comorbidities (4185 (56.2%)) than patients with at least one comorbid condition (3256 (43.8%)), as calculated with the Elixhauser score
We found that age, race, patient region, insurance payer, and Elixhauser score were all variables that significantly affected the type of reconstruction that patients received (Table 2)
Summary
The United States has 3.5 million breast cancer survivors [1]. With an estimated 279,100 new breast cancer diagnoses for 2020 and a steady decrease in mortality, the number of survivors is expected to increase [2,3]. lifesaving, mastectomy is a procedure that can cause significant psychological stress in patients who require it [4]. The United States has 3.5 million breast cancer survivors [1]. With an estimated 279,100 new breast cancer diagnoses for 2020 and a steady decrease in mortality, the number of survivors is expected to increase [2,3]. Mastectomy is a procedure that can cause significant psychological stress in patients who require it [4]. To improve this burden, breast reconstruction has become an important. Implant-based reconstruction is the most common type of reconstruction; women who receive autologous reconstruction have shown a higher rate of satisfaction [9]. We included female patients, diagnosed with breast cancer, who underwent mastectomy and a subsequent breast reconstruction. We performed an χ2 test and logistic regression in this analysis
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