TABLE 4.
Multivariable-adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) associating delay, facility characteristics with breast cancer mortality as well as overall and racial disparities by facility characteristics among 6011 women with breast cancer diagnosed in the metropolitan Atlanta area (2010–2014)
| Deaths (n) |
Overall HR (95 % CI a |
Deaths (n) |
Common referent HR (95 % CI a |
RERI (95 % CI) | Stratified effects HR (95 % CI)b |
|||
|---|---|---|---|---|---|---|---|---|
|
|
|
|||||||
| Overall | NHW | NHB | NHW | NHB | ||||
|
| ||||||||
| Overall disparity | 173 | 189 | – | – | 2.00 (1.63 to 2.46) | |||
| Dx to surgery | ||||||||
| Delay (>30 days) | 226 | 1.11 (0.88 to 1.38) | 90 | 136 | 0.98 (0.73 to 1.34) | 1.46 (1.07 to 1.99) | 0.19 (—0.33 to 0.71) | 2.05 (1.57 to 2.68) |
| No delay (≤30 days) | 136 | Referent | 83 | 53 | Referent | 1.27 (0.87 to 1.85) | Referent | 1.81 (1.28 to 2.56) |
| Dx to surgery | ||||||||
| Delay (>60 days) | 82 | 1.28 (0.99 to 1.66) | 28 | 54 | 1.31 (0.87 to 1.99) | 1.58 (1.10 to 2.26) | −0.19 (−0.93 to 0.55) | 1.62 (1.02 to 2.55) |
| No delay (≤60 days) | 280 | Referent | 145 | 135 | Referent | 1.46 (1.11 to 1.91) | Referent | 1.98 (1.56 to 2.51) |
| Annual patient volume | ||||||||
| Low | 94 | 1.14 (0.89 to 1.47) | 29 | 65 | 1.18 (0.78 to 1.8) | 1.50 (1.07 to 2.12) | −0.09 (−0.76 to 0.58) | 1.87 (1.20 to 2.90) |
| High | 268 | Referent | 144 | 124 | Referent | 1.43 (1.08 to 1.89) | Referent | 1.95 (1.53 to 2.48) |
| Medical school affiliation | ||||||||
| Yes | 108 | Referent | 31 | 99 | Referent | 1.80 (1.12 to 2.89) | Referent | 2.61 (1.72 to 3.95) |
| No | 253 | 1.10 (0.86 to 1.40) | 142 | 111 | 1.37 (0.91 to 2.08) | 1.85 (1.19 to 2.86) | −0.34 (−1.13 to 0.46) | 1.81 (1.41 to 2.32) |
| Facility type | ||||||||
| Government | 51 | 1.06 (0.78 to 1.45) | 27 | 24 | 1.29 (0.84 to 1.98) | 1.27 (0.80 to 2.10) | −0.74 (−1.76 to 0.27) | 1.31 (0.76 to 2.27) |
| For-profit | 67 | 1.25 (0.94 to 1.66) | 26 | 41 | 1.15 (0.74 to 1.80) | 1.88 (1.27 to 2.78) | 0.04 (−0.72 to 0.80) | 2.04 (1.24 to 3.34) |
| Non-profit | 243 | Referent | 120 | 123 | Referent | 1.46 (1.09 to 1.96) | Referent | 2.11 (1.64 to 2.72) |
| Accreditations or affiliations | ||||||||
| COC-accredited | ||||||||
| Yes | 207 | Referent | 120 | 87 | Referent | 1.27 (0.94 to 1.73) | Referent | 1.82 (1.38 to 2.40) |
| No | 155 | 0.98 (0.79 to 1.22) | 53 | 102 | 0.82 (0.58 to 1.14) | 1.36 (1.00 to 1.86) | 0.27 (−0.21 to 0.75) | 2.29 (1.64 to 3.20) |
| NSABP affiliation | ||||||||
| Yes | 267 | Referent | 135 | 132 | Referent | 1.41 (1.06 to 1.88) | Referent | 2.08 (1.63 to 2.64) |
| No | 95 | 1.11 (0.87 to 1.42) | 38 | 57 | 1.11 (0.76 to 1.62) | 1.52 (1.07 to 2.15) | 0.29 (−0.76 to 1.34) | 1.72 (1.14 to 2.60) |
Dx, diagnosis; HR, hazards ratio; CI, confidence interval; RERI, relative excess risk due to interaction; NHW, non-Hispanic White; NHB, non-Hispanic Black; COC, Commission on Cancer; NSABP, National Surgical Adjuvant Breast and Bowel Project
a
Adjusted for age at diagnosis, insurance, subtype, stage, and SES
b
Adjusted for age at diagnosis