Abstract：
OBJECTIVE: To assess social determinants of health impacting patients undergoing gynecologic oncology versus combined gynecologic oncology and urogynecology surgeries.
METHODS: We identified patients who underwent gynecologic oncology surgeries from 2016 to 2019 in the National Inpatient Sample using the International Classification of Diseases-10 codes. Demographics, including race and insurance status, were compared for patients who underwent gynecologic oncology procedures only (Oncologic) and those who underwent concurrent incontinence or pelvic organ prolapse procedures (Urogynecologic-Oncologic). A logistic regression model assessed variables of interest after adjustment for other relevant variables.
RESULTS: From 2016 to 2019 the National Inpatient Sample database contained 389 (1.14%) Urogynecologic-Oncologic cases and 33 796 (98.9%) Oncologic cases. Urogynecologic-Oncologic patients were less likely to be white (62.1% vs 68.8%, p=0.02) and were older (median 67 vs 62 years, p<0.001) than Oncologic patients. The Urogynecologic-Oncologic cohort was less likely to have private insurance as their primary insurance (31.9% vs 38.9%, p=0.01) and was more likely to have Medicare (52.2% vs 42.8%, p=0.01). After multivariable analysis, black (adjusted odds ratio (aOR) 1.41, 95% CI 1.05 to 1.89, p=0.02) and Hispanic patients (aOR 1.53, 95% CI 1.11 to 2.10, p=0.02) remained more likely to undergo Urogynecologic-Oncologic surgeries but the primary expected payer no longer differed significantly between the two groups (p=0.95). Age at admission, patient residence, and teaching location remained significantly different between the groups.
CONCLUSIONS: In this analysis of a large inpatient database we identified notable racial and geographical differences between the cohorts of patients who underwent Urogynecologic-Oncologic and Oncologic procedures.
METHODS: We identified patients who underwent gynecologic oncology surgeries from 2016 to 2019 in the National Inpatient Sample using the International Classification of Diseases-10 codes. Demographics, including race and insurance status, were compared for patients who underwent gynecologic oncology procedures only (Oncologic) and those who underwent concurrent incontinence or pelvic organ prolapse procedures (Urogynecologic-Oncologic). A logistic regression model assessed variables of interest after adjustment for other relevant variables.
RESULTS: From 2016 to 2019 the National Inpatient Sample database contained 389 (1.14%) Urogynecologic-Oncologic cases and 33 796 (98.9%) Oncologic cases. Urogynecologic-Oncologic patients were less likely to be white (62.1% vs 68.8%, p=0.02) and were older (median 67 vs 62 years, p<0.001) than Oncologic patients. The Urogynecologic-Oncologic cohort was less likely to have private insurance as their primary insurance (31.9% vs 38.9%, p=0.01) and was more likely to have Medicare (52.2% vs 42.8%, p=0.01). After multivariable analysis, black (adjusted odds ratio (aOR) 1.41, 95% CI 1.05 to 1.89, p=0.02) and Hispanic patients (aOR 1.53, 95% CI 1.11 to 2.10, p=0.02) remained more likely to undergo Urogynecologic-Oncologic surgeries but the primary expected payer no longer differed significantly between the two groups (p=0.95). Age at admission, patient residence, and teaching location remained significantly different between the groups.
CONCLUSIONS: In this analysis of a large inpatient database we identified notable racial and geographical differences between the cohorts of patients who underwent Urogynecologic-Oncologic and Oncologic procedures.
摘要：
目的：评估妇科肿瘤和泌尿外科联合手术对妇科肿瘤患者健康影响的社会决定因素。
方法：我们使用国际疾病分类-10代码在国家住院患者样本中确定了2016年至2019年接受妇科肿瘤手术的患者。人口统计,包括种族和保险状况,比较了仅接受妇科肿瘤学手术（肿瘤学）和并发失禁或盆腔器官脱垂手术（妇科-肿瘤学）的患者。逻辑回归模型在对其他相关变量进行调整后评估了感兴趣的变量。
结果：从2016年到2019年，全国住院患者样本数据库包含389例（1.14％）妇科肿瘤病例和33796例（98.9％）肿瘤病例。泌尿妇科-肿瘤患者不太可能是白人（62.1％vs68.8％，p=0.02)，年龄较大(中位数为67岁vs62岁，p<0.001）比肿瘤患者。妇科-肿瘤队列不太可能将私人保险作为他们的主要保险(31.9%vs38.9%，p=0.01)，并且更有可能获得医疗保险(52.2%对42.8%，p=0.01)。经过多变量分析，黑人(校正比值比(aOR)1.41,95%CI1.05~1.89,p=0.02)和西班牙裔患者(aOR1.53,95%CI1.11~2.10,p=0.02)仍更有可能接受妇科-肿瘤手术,但两组的主要预期付款人不再有显著差异(p=0.95).入院时的年龄，患者住所,两组之间的教学地点仍然存在显着差异。
结论：在对大型住院患者数据库的分析中，我们发现接受泌尿外科-肿瘤和肿瘤手术的患者队列之间存在显著的种族和地理差异。
方法：我们使用国际疾病分类-10代码在国家住院患者样本中确定了2016年至2019年接受妇科肿瘤手术的患者。人口统计,包括种族和保险状况,比较了仅接受妇科肿瘤学手术（肿瘤学）和并发失禁或盆腔器官脱垂手术（妇科-肿瘤学）的患者。逻辑回归模型在对其他相关变量进行调整后评估了感兴趣的变量。
结果：从2016年到2019年，全国住院患者样本数据库包含389例（1.14％）妇科肿瘤病例和33796例（98.9％）肿瘤病例。泌尿妇科-肿瘤患者不太可能是白人（62.1％vs68.8％，p=0.02)，年龄较大(中位数为67岁vs62岁，p<0.001）比肿瘤患者。妇科-肿瘤队列不太可能将私人保险作为他们的主要保险(31.9%vs38.9%，p=0.01)，并且更有可能获得医疗保险(52.2%对42.8%，p=0.01)。经过多变量分析，黑人(校正比值比(aOR)1.41,95%CI1.05~1.89,p=0.02)和西班牙裔患者(aOR1.53,95%CI1.11~2.10,p=0.02)仍更有可能接受妇科-肿瘤手术,但两组的主要预期付款人不再有显著差异(p=0.95).入院时的年龄，患者住所,两组之间的教学地点仍然存在显着差异。
结论：在对大型住院患者数据库的分析中，我们发现接受泌尿外科-肿瘤和肿瘤手术的患者队列之间存在显著的种族和地理差异。
