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Submuscular and Pre-pectoral ADM Assisted Immediate Breast Reconstruction: A Literature Review
Open AccessArticle

Disparities in Access to Autologous Breast Reconstruction

1
Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
2
Department of Plastic Surgery, Cleveland Clinic, OH 44195, USA
3
Division of Plastic Surgery, Mayo Clinic, Rochester, MN 55905, USA
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Department of Health Science Research, Mayo Clinic, Jacksonville, FL 32224, USA
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Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(6), 281; https://doi.org/10.3390/medicina56060281
Received: 5 May 2020 / Revised: 26 May 2020 / Accepted: 4 June 2020 / Published: 8 June 2020
(This article belongs to the Special Issue Updates in Breast Reconstruction: Review from Evidence)
Background and objectives: This study aimed to determine if age, race, region, insurance, and comorbidities affect the type of breast reconstruction that patients receive. Materials and methods: This analysis used the Florida Inpatient Discharge Dataset from 1 January 2013 to 30 September 2017, which contains deidentified patient-level administrative data from all acute care hospitals in the state of Florida. We included female patients, diagnosed with breast cancer, who underwent mastectomy and a subsequent breast reconstruction. We performed an χ2 test and logistic regression in this analysis. Results: On the multivariable analysis, we found that age, race, patient region, insurance payer, and Elixhauser score were all variables that significantly affected the type of reconstruction that patients received. Our results show that African American (odds ratio (OR): 0.68, 95%CI: 0.58–0.78, p < 0.001) and Hispanic or Latino (OR: 0.82, 95%CI: 0.72–0.93, p = 0.003) patients have significantly lower odds of receiving implant reconstruction when compared to white patients. Patients with Medicare (OR: 1.57, 95%CI: 1.33–1.86, p < 0.001) had significantly higher odds and patients with Medicaid (OR: 0.61, 95%CI: 0.51–0.74, p < 0.001) had significantly lower odds of getting autologous reconstruction when compared to patients with commercial insurance. Conclusions: Our study demonstrated that, in the state of Florida over the past years, variables, such as race, region, insurance, and comorbidities, play an important role in choosing the reconstruction modality. More efforts are needed to eradicate disparities and give all patients, despite their race, insurance payer, or region, equal access to health care. View Full-Text
Keywords: breast cancer; breast reconstruction; autologous reconstruction; disparities; public health; Florida breast cancer; breast reconstruction; autologous reconstruction; disparities; public health; Florida
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Restrepo, D.J.; Huayllani, M.T.; Boczar, D.; Sisti, A.; Nguyen, M.-D.T.; Cochuyt, J.J.; Spaulding, A.C.; Rinker, B.D.; Perdikis, G.; Forte, A.J. Disparities in Access to Autologous Breast Reconstruction. Medicina 2020, 56, 281.

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