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.
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。