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[PMID]:29359900
[Au] Autor:Steiner DJ; Thomson Reuters Accelus.
[Ti] Título:Emergency care.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-40, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/organização & administração
Serviço Hospitalar de Emergência/organização & administração
[Mh] Termos MeSH secundário: Assistência Ambulatorial
Instituições de Assistência Ambulatorial
Reforma dos Serviços de Saúde
Gastos em Saúde
Acesso aos Serviços de Saúde
Linhas Diretas
Seres Humanos
Cobertura do Seguro/economia
Seguro Saúde/economia
Reembolso de Seguro de Saúde
Tempo de Internação
Serviços de Saúde Mental
Mortalidade
Transtornos Relacionados ao Uso de Opioides
Cuidados Paliativos
Patient Protection and Affordable Care Act
Projetos Piloto
Reembolso de Incentivo
Serviços de Saúde Rural
Provedores de Redes de Segurança
Governo Estadual
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


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[PMID]:29365282
[Au] Autor:Desai S; McWilliams JM
[Ad] Endereço:From the Department of Population Health, New York University, New York (S.D.); and the Department of Health Care Policy, Harvard Medical School (S.D., J.M.M.), and the Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital (J.M.M.) - both in Boston.
[Ti] Título:Consequences of the 340B Drug Pricing Program.
[So] Source:N Engl J Med;378(6):539-548, 2018 02 08.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The 340B Drug Pricing Program entitles qualifying hospitals to discounts on outpatient drugs, increasing the profitability of drug administration. By tying the program eligibility of hospitals to their Disproportionate Share Hospital (DSH) adjustment percentage, which reflects the proportion of hospitalized patients who are low-income, the program is intended to expand resources for underserved populations but provides no direct incentives for hospitals to use financial gains to enhance care for low-income patients. METHODS: We used Medicare claims and a regression-discontinuity design, taking advantage of the threshold for program eligibility among general acute care hospitals (DSH percentage, >11.75%), to isolate the effects of the program on hospital-physician consolidation (i.e., acquisition of physician practices or employment of physicians by hospitals) and on the outpatient administration of parenteral drugs by hospital-owned facilities in three specialties in which parenteral drugs are frequently used. For low-income patients, we also assessed the effects of the program on the provision of care by hospitals and on mortality. RESULTS: Hospital eligibility for the 340B Program was associated with 2.3 more hematologist-oncologists practicing in facilities owned by the hospital, or 230% more hematologist-oncologists than expected in the absence of the program (P=0.02), and with 0.9 (or 900%) more ophthalmologists per hospital (P=0.08) and 0.1 (or 33%) more rheumatologists per hospital (P=0.84). Program eligibility was associated with significantly higher numbers of parenteral drug claims billed by hospitals for Medicare patients in hematology-oncology (90% higher, P=0.001) and ophthalmology (177% higher, P=0.03) but not rheumatology (77% higher, P=0.12). Program eligibility was associated with lower proportions of low-income patients in hematology-oncology and ophthalmology and with no significant differences in hospital provision of safety-net or inpatient care for low-income groups or in mortality among low-income residents of the hospitals' local service areas. CONCLUSIONS: The 340B Program has been associated with hospital-physician consolidation in hematology-oncology and with more hospital-based administration of parenteral drugs in hematology-oncology and ophthalmology. Financial gains for hospitals have not been associated with clear evidence of expanded care or lower mortality among low-income patients. (Funded by the Agency for Healthcare Research and Quality and others.).
[Mh] Termos MeSH primário: Custos de Medicamentos
Economia Hospitalar
Convênios Médico-Hospitalares/estatística & dados numéricos
Medicare Part B/economia
Pobreza
Mecanismo de Reembolso
[Mh] Termos MeSH secundário: Custos e Análise de Custo
Hematologia
Hospitais/estatística & dados numéricos
Seres Humanos
Oncologia
Mortalidade
Oftalmologia
Propriedade
Provedores de Redes de Segurança/economia
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMsa1706475


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[PMID]:28745137
[Au] Autor:Enard KR; Ganelin DM
[Ad] Endereço:1 Saint Louis University, Saint Louis, MO, USA.
[Ti] Título:Exploring the Value Proposition of Primary Care for Safety-Net Patients Who Utilize Emergency Departments to Address Unmet Needs.
[So] Source:J Prim Care Community Health;8(4):285-293, 2017 Oct.
[Is] ISSN:2150-1327
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: An underlying assumption of strategies intended to promote appropriate primary care over emergency department (ED) use for ongoing health care needs is that patients will understand the "value proposition" of primary care: that they will receive specific benefits from primary care providers over and above what they receive from EDs. However, there is evidence that this value proposition may be unclear to safety-net patients. The goals of this study are to describe factors motivating ED use for low-acuity conditions; describe similarities and differences in usual source of care (USOC) experiences, by ED versus non-ED setting; and assess awareness and perceptions of the patient-centered medical home (PCMH) concept among safety-net patients. METHODS: We conducted a cross-sectional descriptive study of adult patients (n = 329) at 3 safety-net hospitals in the Southwest. RESULTS: Key reasons for ED use were perceived urgency, lack of awareness about other options for care, payment flexibility, and perceived quality and convenience. Approximately half of participants indicated they would seek treatment in non-ED settings, if available, but agreement differed by group (non-ED USOC, 60.2%; ED USOC, 50.7%; no USOC, 45.3%; P = .025). Agreement that providers coordinated access to needed medical services was significantly higher among patients with non-ED USOCs; agreement that providers coordinated non-medical services that facilitate access to care was similar (approximately 45%) for patients with ED and non-ED USOCs. Approximately 70% of participants in both groups agreed that every person should have a medical home. CONCLUSIONS: Perceived experiences of care in ED and non-ED USOC settings suggest challenges and opportunities for increasing the value proposition of primary care for safety-net patients. Although patients are receptive to the PCMH concept, effective strategies to better highlight the value of primary care in coordinating both medical and related nonmedical services and other PCMH benefits warrant further investigation.
[Mh] Termos MeSH primário: Atitude Frente à Saúde
Necessidades e Demandas de Serviços de Saúde
Assistência Centrada no Paciente
Atenção Primária à Saúde
Provedores de Redes de Segurança
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos Transversais
Serviço Hospitalar de Emergência
Feminino
Acesso aos Serviços de Saúde
Disparidades em Assistência à Saúde
Seres Humanos
Masculino
Meia-Idade
Motivação
Qualidade da Assistência à Saúde
Texas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1177/2150131917721652


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[PMID]:29362789
[Au] Autor:Abbasi J
[Ti] Título:Shantanu Nundy, MD: The Human Diagnosis Project.
[So] Source:JAMA;319(4):329-331, 2018 Jan 23.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aprendizado de Máquina
Consulta Remota
[Mh] Termos MeSH secundário: Diagnóstico
Educação Médica Continuada
Seres Humanos
Provedores de Redes de Segurança
Sociedades
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.13897


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[PMID]:27776246
[Au] Autor:Ma P; Kendzor DE; Poonawalla IB; Balis DS; Businelle MS
[Ad] Endereço:Children's Health/Children's Medical Center at Dallas, Dallas, TX, United States. Electronic address: ping.ma@childrens.com.
[Ti] Título:Daily nicotine patch wear time predicts smoking abstinence in socioeconomically disadvantaged adults: An analysis of ecological momentary assessment data.
[So] Source:Drug Alcohol Depend;169:64-67, 2016 12 01.
[Is] ISSN:1879-0046
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Individuals who use the nicotine patch are more likely to quit smoking than those who receive placebo or no medication. However, studies have not yet examined the association between actual daily nicotine patch wear time during the early phase of a smoking cessation attempt and later smoking abstinence. The purpose of this study was to address this gap in the literature. METHODS: Participants who enrolled in a safety-net hospital smoking cessation program were followed for 13 weeks (i.e., 1 week pre-quit through 12 weeks post-quit). Participants completed in-person assessments and daily ecological momentary assessments on study provided smartphones. Multivariate logistic regressions were used to determine if daily patch wear time during the first week post-quit predicted 7-day biochemically verified point prevalence smoking abstinence 4 and 12 weeks following the scheduled quit date. Demographic characteristics and smoking behaviors were adjusted as covariates. RESULTS: Participants (N=74) were primarily non-White (78.7%) and most (86%) had an annual household income of <$20,000. Greater average hours of daily nicotine patch wear time during the first week post-quit was associated with a greater likelihood of abstinence at the 4 and 12 week post-quit visits (aOR=2.22, 95% CI:1.17-4.23; aOR=2.24, 95% CI:1.00-5.03). Furthermore, more days of wearing the patch for ≥19h was associated with a greater likelihood of abstinence at the 4 and 12 week post-quit visits (aOR=1.81, 95% CI:1.01-3.22; aOR=2.18, 95% CI:1.03-4.63). CONCLUSIONS: Greater adherence to the nicotine patch early in a quit attempt may increase the likelihood of smoking cessation among socioeconomically disadvantaged adults.
[Mh] Termos MeSH primário: Nicotina/uso terapêutico
Abandono do Hábito de Fumar/métodos
Fumar/epidemiologia
Produtos para o Abandono do Uso de Tabaco/utilização
Populações Vulneráveis
[Mh] Termos MeSH secundário: Adulto
Avaliação Momentânea Ecológica
Feminino
Seres Humanos
Masculino
Meia-Idade
Nicotina/administração & dosagem
Prevalência
Provedores de Redes de Segurança
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
6M3C89ZY6R (Nicotine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180122
[Lr] Data última revisão:
180122
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29292321
[Au] Autor:Simon L; Shroff D; Barrow J; Park SE
[Ad] Endereço:Dr. Simon is a Fellow in Oral Health and Medicine Integration, Harvard School of Dental Medicine and an MD student, Harvard Medical School; Deepti Shroff is a DMD student, Harvard School of Dental Medicine; Ms. Barrow is Associate Dean, Office of Global and Community Health, Harvard School of Dental
[Ti] Título:A Reflection Curriculum for Longitudinal Community-Based Clinical Experiences: Impact on Student Perceptions of the Safety Net.
[So] Source:J Dent Educ;82(1):12-19, 2018 Jan.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Community-based dental education (CBDE) allows dental students to be immersed in community settings and provide care to populations that are underserved. Exposure to those groups during training may impact provider attitudes, which may be strengthened by supporting students' reflection and exploration of their own attitudes. The aim of this study was to describe the implementation and preliminary results of a pilot longitudinal reflection curriculum integrated into a community-based clinical experience (CBCE) for senior dental students at one U.S. dental school and to report the impact of the reflection curriculum and CBCE on student experiences with populations that are underserved. In academic year 2015-16, all 35 senior dental students at one U.S. dental school were invited to complete an 11-item survey before and after completing a 12-week CBCE with integrated, longitudinal online reflections. Students received feedback from a faculty member after each reflection. All 35 students completed the survey, for a 100% response rate. After the CBCE, the students reported improved clinical efficiency and increased confidence in treatment planning and in treating dental emergencies and dentally anxious patients. They also reported improved understanding of the structure and relevance of community health centers, the role of different health care team members, and the impact of health policy. There was no significant difference in future plans to work with groups that are underserved. These results suggest that the CBCE and reflection curriculum had a positive impact on the students' clinical confidence as well as expanding their understanding of the broader oral health care delivery system. To address persistent oral health disparities, dental schools should continue to adopt CBDE programming that will prepare providers to effectively care for populations that are underserved.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Odontologia Comunitária/educação
Serviços de Saúde Comunitária
Educação em Odontologia
Provedores de Redes de Segurança
Estudantes de Odontologia/psicologia
[Mh] Termos MeSH secundário: Boston
Currículo
Área Carente de Assistência Médica
Autorrelato
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.018.004


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[PMID]:29232088
[Au] Autor:Dobson A; DaVanzo JE; Haught R; Phap-Hoa L
[Ad] Endereço:Dobson DaVanzo & Associates, LLC.
[Ti] Título:Comparing the Affordable Care Act's Financial Impact on Safety-Net Hospitals in States That Expanded Medicaid and Those That Did Not.
[So] Source:Issue Brief (Commonw Fund);2017:1-10, 2017 Nov 01.
[Is] ISSN:1558-6847
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Issue: Safety-net hospitals play a vital role in delivering health care to Medicaid enrollees, the uninsured, and other vulnerable patients. By reducing the number of uninsured Americans, the Affordable Care Act (ACA) was also expected to lower these hospitals' significant uncompensated care costs and shore up their financial stability. Goal: To examine how the ACA's Medicaid expansion affected the financial status of safety-net hospitals in states that expanded Medicaid and in states that did not. Methods: Using Medicare hospital cost reports for federal fiscal years 2012 and 2015, the authors compared changes in Medicaid inpatient days as a percentage of total inpatient days, Medicaid revenues as a percentage of total net patient revenues, uncompensated care costs as a percentage of total operating costs, and hospital operating margins. Findings and Conclusions: Medicaid expansion had a significant, favorable financial impact on safety-net hospitals. From 2012 to 2015, safety-net hospitals in expansion states, compared to those in nonexpansion states, experienced larger increases in Medicaid inpatient days and Medicaid revenues as well as reduced uncompensated care costs. These changes improved operating margins for safety-net hospitals in expansion states. Margins for safety-net hospitals in nonexpansion states, meanwhile, declined.
[Mh] Termos MeSH primário: Economia Hospitalar/legislação & jurisprudência
Economia Hospitalar/estatística & dados numéricos
Medicaid/economia
Medicaid/legislação & jurisprudência
Patient Protection and Affordable Care Act/economia
Provedores de Redes de Segurança/economia
Provedores de Redes de Segurança/legislação & jurisprudência
Cuidados de Saúde não Remunerados/economia
Cuidados de Saúde não Remunerados/legislação & jurisprudência
[Mh] Termos MeSH secundário: Seres Humanos
Medicaid/estatística & dados numéricos
Provedores de Redes de Segurança/estatística & dados numéricos
Governo Estadual
Cuidados de Saúde não Remunerados/estatística & dados numéricos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE


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[PMID]:29229155
[Au] Autor:Castellanos SA; Buentello G; Gutierrez-Meza D; Forgues A; Haubert L; Artinyan A; Macdonald CL; Suliburk JW
[Ad] Endereço:Baylor College of Medicine, Michael E. Debakey Department of Surgery, Houston, Texas.
[Ti] Título:Use of Game Theory to model patient engagement after surgery: a qualitative analysis.
[So] Source:J Surg Res;221:69-76, 2018 Jan.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patient engagement is challenging to define and operationalize. Qualitative analysis allows us to explore patient perspectives on this topic and establish themes. A game theoretic signaling model also provides a framework through which to further explore engagement. METHODS: Over a 6-mo period, thirty-eight interviews were conducted within 6 wk of discharge in patients undergoing thyroid, parathyroid, or colorectal surgery. Interviews were transcribed, anonymized, and analyzed using the NVivo 11 platform. A signaling model was then developed depicting the doctor-patient interaction surrounding the patient's choice to reach out to their physician with postoperative concerns based upon the patient's perspective of the doctor's availability. This was defined as "engagement". We applied the model to the qualitative data to determine possible causations for a patient's engagement or lack thereof. A private hospital's and a safety net hospital's populations were contrasted. RESULTS: The private patient population was more likely to engage than their safety-net counterparts. Using our model in conjunction with patient data, we determined possible etiologies for this engagement to be due to the private patient's perceived probability of dealing with an available doctor and apparent signals from the doctor indicating so. For the safety-net population, decreased access to care caused them to be less willing to engage with a doctor perceived as possibly unavailable. CONCLUSIONS: A physician who understands these Game Theory concepts may be able to alter their interactions with their patients, tailoring responses and demeanor to fit the patient's circumstances and possible barriers to engagement.
[Mh] Termos MeSH primário: Teoria do Jogo
Modelos Teóricos
Participação do Paciente
Cuidados Pós-Operatórios/psicologia
Período Pós-Operatório
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Hospitais Privados
Seres Humanos
Masculino
Meia-Idade
Provedores de Redes de Segurança
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE


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[PMID]:29229129
[Au] Autor:Hoehn RS; Go DE; Hanseman DJ; Shah SA; Paquette IM
[Ad] Endereço:Department of Surgery, Cincinnati Research in Outcomes and Safety in Surgery (CROSS), University of Cincinnati College of Medicine, Cincinnati, Ohio.
[Ti] Título:Hospital safety-net burden does not predict differences in rectal cancer treatment and outcomes.
[So] Source:J Surg Res;221:204-210, 2018 Jan.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Safety-net hospitals have been shown to have inferior short-term surgical outcomes. The aim of this study was to compare rectal cancer management and survival across hospitals stratified by payer mix. MATERIALS AND METHODS: Rectal cancer patients (n = 296,068) were identified using the 1998-2010 National Cancer Data Base. Hospitals were grouped into safety-net burden categories, according to the proportion of patients with Medicaid or no health insurance, as follows: low-, medium-, and high-burden hospitals (HBHs). Patient and tumor characteristics, processes of care, and outcomes were evaluated, and regression analysis was used to investigate correlations between hospital safety-net burden on patient survival. RESULTS: HBH encountered patients with more advanced disease (P < 0.001). Despite this, stage I-III patients at HBH had equal likelihood of receiving surgery and guideline-appropriate radiation and chemotherapy (all P > 0.05). The 30-day readmissions and mortality were also similar across safety-net groups (all P > 0.05). Multivariate analysis showed no difference in survival between HBH and low-burden hospital (P = 0.164). CONCLUSIONS: Hospital payer mix may not adversely influence management of rectal cancer. This study highlights potential areas to improve cancer care for vulnerable patient populations.
[Mh] Termos MeSH primário: Readmissão do Paciente/estatística & dados numéricos
Neoplasias Retais/mortalidade
Provedores de Redes de Segurança/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Neoplasias Retais/terapia
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE


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[PMID]:29219921
[Au] Autor:Althans AR; Brady JT; Times ML; Keller DS; Harvey AR; Kelly ME; Patel ND; Steele SR
[Ad] Endereço:Case Western Reserve University School of Medicine, Cleveland, Ohio.
[Ti] Título:Colorectal Cancer Safety Net: Is It Catching Patients Appropriately?
[So] Source:Dis Colon Rectum;61(1):115-123, 2018 Jan.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Disparities in access to colorectal cancer care are multifactorial and are affected by socioeconomic elements. Uninsured and Medicaid patients present with advanced stage disease and have worse outcomes compared with similar privately insured patients. Safety net hospitals are a major care provider to this vulnerable population. Few studies have evaluated outcomes for safety net hospitals compared with private institutions in colorectal cancer. OBJECTIVE: The purpose of this study was to compare demographics, screening rates, presentation stage, and survival rates between a safety net hospital and a tertiary care center. DESIGN: Comparative review of patients at 2 institutions in the same metropolitan area were conducted. SETTINGS: The study included colorectal cancer care delivered either at 1 safety net hospital or 1 private tertiary care center in the same city from 2010 to 2016. PATIENTS: A total of 350 patients with colorectal cancer from each hospital were evaluated. MAIN OUTCOME MEASURES: Overall survival across hospital systems was measured. RESULTS: The safety net hospital had significantly more uninsured and Medicaid patients (46% vs 13%; p < 0.001) and a significantly lower median household income than the tertiary care center ($39,299 vs $49,741; p < 0.0001). At initial presentation, a similar percentage of patients at each hospital presented with stage IV disease (26% vs 20%; p = 0.06). For those undergoing resection, final pathologic stage distribution was similar across groups (p = 0.10). After a comparable median follow-up period (26.6 mo for safety net hospital vs 29.2 mo for tertiary care center), log-rank test for overall survival favored the safety net hospital (p = 0.05); disease-free survival was similar between hospitals (p = 0.40). LIMITATIONS: This was a retrospective review, reporting from medical charts. CONCLUSIONS: Our results support the value of safety net hospitals for providing quality colorectal cancer care, with survival and recurrence outcomes equivalent or improved compared with a local tertiary care center. Because safety net hospitals can provide equivalent outcomes despite socioeconomic inequalities and financial constraints, emphasis should be focused on ensuring that adequate funding for these institutions continues. See Video Abstract at http://links.lww.com/DCR/A454.
[Mh] Termos MeSH primário: Neoplasias Colorretais/diagnóstico
Neoplasias Colorretais/terapia
Disparidades em Assistência à Saúde/estatística & dados numéricos
Provedores de Redes de Segurança/normas
Centros de Atenção Terciária/normas
[Mh] Termos MeSH secundário: Neoplasias Colorretais/mortalidade
Acesso aos Serviços de Saúde/estatística & dados numéricos
Seres Humanos
Medicaid/estatística & dados numéricos
Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos
Qualidade da Assistência à Saúde
Estudos Retrospectivos
Provedores de Redes de Segurança/estatística & dados numéricos
Análise de Sobrevida
Centros de Atenção Terciária/estatística & dados numéricos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000944



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BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde