Unequal access: Hispanic children rarely get top-notch care for brain tumors

http://www.eurekalert.org/pub_releases/2009-10/jhmi-uah100809.php

Public release date: 8-Oct-2009
Contact: Ekaterina Pesheva
Johns Hopkins Medical Institutions
Unequal access: Hispanic children rarely get top-notch care for brain tumors

Hispanic children diagnosed with brain tumors get high-quality treatment at hospitals that specialize in neurosurgery far less often than other children with the same condition, potentially compromising their immediate prognosis and long-term survival, according to research from Johns Hopkins published in October's Pediatrics.

More than a decade after the Institute of Medicine's landmark report Crossing the Quality Chasm, the Hopkins investigators say their findings detect persistent gaps in access to specialized care among certain patients, raising questions about how far across the chasm we have actually come.

"What was shocking to us was the finding that, despite the push over the last decade to equalize access to high-quality care, gaps are still there, particularly among Hispanics, and, if anything, they may be getting even worse," said lead investigator Raj Mukherjee, M.D., M.P.H., a postdoctoral fellow in the Department of Neurosurgery at Hopkins.

Research has shown that patients treated at specialty hospitals that admit a high volume of patients with similar conditions fare better in the long and short term, investigators say. For example, studies show that patients undergoing brain surgeries in hospitals that perform the fewest neurosurgeries have up to 16 times the mortality rate of patients treated in hospitals performing the highest number.

"Given that brain tumors are the most common solid tumors in children, lack of access to specialized care simply means that thousands of pediatric patients are getting less-than-optimal treatment, putting them at risk for relapse and a host of neurological complications," says pediatric neurosurgeon George Jallo, M.D., co-author on the study and director of Neurosurgery at Johns Hopkins Children's Center.

-----