Sociodemographic Factors That Influence Access to Quality Care: Age, Race, and Insurance Status

摘要

Given the tremendous impact that quality of cancer care may have on clinical outcome, any factor that affects one's ability to access quality care is likely to impact on clinical outcome. Nonclinical patient characteristics such as age, race or ethnicity, and socioeconomic status have all been demonstrated to affect a patient's access to quality cancer care. Older age, nonwhite race, and being under- or uninsured have all been demonstrated to place a patient at increased risk of less aggressive treatment and to increase the likelihood that treatment will deviate from recommended guidelines.These factors have also been associated with shorter time until death due to cancer. Some of these differences in survival rates may be attributed to the fact that the elderly, African-Americans, certain other minorities, and individuals who are uninsured or have Medicaid are significantly more likely to be diagnosed with later-stage disease than for other groups.However, not all the disparities in care and survival rates are related to differences in the stage at presentation and access to care. The disparities in care between various racial and ethnic groups were the subject of another recent IOM report entitled, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.