Stalled at the intersection: insurance status and disparities in post-mastectomy breast reconstruction

Purpose Post-mastectomy breast reconstruction (PMBR) is an important component of breast cancer treatment, but disparities relative to insurance status persist despite legislation targeting the issue. We aimed to study this relationship in a large health system combining a safety-net hospital and a...

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Bibliographic Details
Published in:Breast cancer research and treatment 2022-07, Vol.194 (2), p.327-335
Main Authors: Friedman-Eldar, Orli, Burke, Jonathan, de Castro Silva, Iago, Baumrucker, Camille C., Valle, Fernando, Lessard, Anne-Sophie, Kassira, Wrood, Franceschi, Dido, Kesmodel, Susan B., Avisar, Eli, Goel, Neha, Möller, Mecker G.
Format: Article
Language:English
Subjects:
Breast cancer
Cancer
Cancer research
Care and treatment
Clinical Trial
Insurance law
Legislation
Mammaplasty
Mastectomy
Medicaid
Medical colleges
Medically uninsured persons
Medicare
Medicine
Medicine & Public Health
Oncology
Patients
Reconstructive surgery
Uninsured people
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Summary:Purpose Post-mastectomy breast reconstruction (PMBR) is an important component of breast cancer treatment, but disparities relative to insurance status persist despite legislation targeting the issue. We aimed to study this relationship in a large health system combining a safety-net hospital and a private academic center. Methods Data were collected on all patients who underwent mastectomy for breast cancer from 2011 to 2019 in a private academic center and an adjacent public safety-net hospital served by the same surgical teams. Multivariable logistic regression was used to assess the effect of insurance status on PMBR, controlling for covariates that included socioeconomic, demographic, and clinical factors. Results Of 1554 patients undergoing mastectomy for breast cancer, 753 (48.5%) underwent PMBR, of which 592 (79.9%) were privately insured, 50 (6.7%) Medicare, 68 (9.2%) Medicaid, and 31 (4.2%) uninsured. Multivariable logistic regression showed a significantly higher likelihood of not undergoing PMBR for uninsured (OR 6.0, 95% CI 3.7–9.8; p  
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-022-06639-8