Racial disparities in hospital outcomes for uterine and ovarian cancer patients: A National Inpatient Sample database (NIS) analysis.

Abstract

e17645 Background: Racial disparities in healthcare outcomes are well-reported in different medical conditions. In this study, we aimed to explore the racial disparities in hospital outcomes of patients admitted to United States (US) hospitals with two common gynecological cancers, ovarian and uterine. Methods: We analyzed data using the National Inpatient Sample Database (NIS) from 2017 to 2020. ICD-10 codes were used to diagnose patients with female genital tract cancers (uterine and ovarian cancers). The chi-square test was used to compare categorical variables, and the t-test was used to compare continuous variables. Using NIS, we examined the association between race and hospitalization outcomes in female patients with gynecological cancers. Results: Out of a total of 83,019 patients with uterine cancer, 58% were non-Hispanic (NH) White, 22% were NH Black, 10% were Hispanic, and the remaining 10% belonged to other racial groups. Regardless of race, 76% of the patients were admitted to urban teaching hospitals, 23% of the admissions were elective, and 77% were non-elective. The majority of the patients (64%) were < 70 years of age (mean age = 65 years). In the adjusted analysis, the NH White race had a higher length of stay (75%) (p-value 0.00). Most of the NH Black population was discharged to routine homes (47%) compared to other races (p-value 0.00). However, the mortality rate was lowest among the NH White population (5% as compared to other races). The cost of hospitalization was found to be higher in the hospital admission of Hispanic patients (p-value 0.00) as compared to other races. A total of 396,834 patients were detected with ovarian cancer. Regardless of age, 80% of the patients were admitted to urban teaching hospitals, 30% of the admissions were elective, and 70% were non-elective. The majority of patients (63%) were < 70 years old (mean age was 63 years). In the adjusted analysis, the NH Black population had the lowest length of stay (p-value 0.00). Hispanics had the highest discharge to routine homes (65%), while the mortality rate was highest among the NH Black population (8%) (p-value 0.00). The total cost of hospitalization was higher in Hispanics ($14050) as compared to other races (p-value 0.00). Conclusions: Our study reveals that NH White patients with uterine cancer had longer hospital stays but lower mortality rates, while NH Black patients were more often discharged to routine homes. For ovarian cancer, NH Black patients had the shortest hospital stays but the highest mortality rates, and Hispanic patients faced higher hospitalization costs. These disparities highlight the need for targeted interventions to improve equity in gynecological cancer care.