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(HealthDay News) — Many women undergoing breast-conserving surgery (BCS) or mastectomy bypass their nearest hospitals, according to a study published online Jan. 8 in Cancer.
Ajay Aggarwal, M.D., Ph.D., from the London School of Hygiene and Tropical Medicine, and colleagues used linked administrative datasets from the English National Health Service to identify all women who underwent BCS or mastectomy with or without immediate breast reconstruction. A geographic information system was used to examine the extent to which patients bypassed their nearest hospital.
The researchers found that 32.7 percent of the 69,153 patients undergoing BCS and 30.5 percent of the 23,536 patients undergoing mastectomy bypassed their nearest hospital. The likelihood of traveling to more distant hospitals was increased for women who were younger, who had no comorbidities, and were from rural areas. Despite not undergoing reconstruction, women undergoing BCS or mastectomy were more likely to be treated at specialist breast reconstruction centers (odds ratios, 1.85 and 1.52, respectively). The likelihood of traveling to hospitals employing surgeons who had a media reputation was increased for patients receiving mastectomy and immediate breast reconstruction (odds ratio, 2.41). The likelihood of traveling to hospitals with shorter waiting time was lower for patients undergoing BCS (odds ratio, 0.65).
“Patients seem to be influenced by the reputation of hospitals and their surgeons, particularly those performing advanced breast‐reconstruction techniques,” the authors write. “This highlights that policies offering patients with breast cancer the opportunity to choose where they have their treatment may drive inequalities in the health care system without necessarily improving patient outcomes.”
One author disclosed ties to the pharmaceutical industry.
