Assessment of socioeconomic and racial differences in patients undergoing concurrent gynecologic oncology and urogynecology surgeries: a National Inpatient Sample (NIS) database study

• Published in: International journal of gynecological cancer Vol. 34; no. 5; pp. 751 - 759
• Main Authors: Marcu, Ioana, McLaughlin, Eric M, Nekkanti, Silpa, Khadraoui, Wafa, Chalif, Julia, Fulton, Jessica, O’Malley, David, Chambers, Laura M
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.05.2024; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Codes; Databases, Factual; Ethnicity; Family income; Female; Frailty; Genital Neoplasms, Female - surgery; Geography; Gynecologic Surgical Procedures; Gynecologic Surgical Procedures - statistics & numerical data; Gynecology; Hospitals; Humans; Medicare; Middle Aged; Oncology; Original research; Ovarian cancer; Patients; Pelvic organ prolapse; Pelvic Organ Prolapse - surgery; Pelvis; Race; Socioeconomic Factors; Socioeconomic status; Surgery; Surgical Oncology; Surgical Procedures, Operative; United States - epidemiology; Urinary incontinence; Uterine cancer; Variables; Womens health; United States; United States > US; Gynecologic Surgical Procedures; Surgical Procedures, Operative; Surgical Oncology; Gynecology
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1136/ijgc-2023-005130

ObjectiveTo assess social determinants of health impacting patients undergoing gynecologic oncology versus combined gynecologic oncology and urogynecology surgeries.MethodsWe 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.ResultsFrom 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.ConclusionsIn 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.