Racial disparities in postmastectomy breast reconstruction following implementation of the affordable care act: A systematic review using a minority health and disparities research framework. Am J Surg 2023 Jul;226(1):37-47
Date
01/28/2023Pubmed ID
36707301DOI
10.1016/j.amjsurg.2023.01.013Scopus ID
2-s2.0-85147226714 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
BACKGROUND: This systematic review assesses racial disparities for African American (AA) women in breast reconstruction following the implementation of the Affordable Care Act.
METHODS: Four databases (Ovid Medline, PubMed, Scopus, Web of Science) were searched for peer-reviewed articles published between January 2011 and September 2021.
RESULTS: Out of 917 screened articles, 61 were included. The most common metrics were breast reconstruction rates (57.4%) and clinical outcomes (14.8%). Pooled reconstruction rates were 45.7% in white and 38.5% in AA women. 95.1% of studies found disparities in breast reconstruction rates. The greatest influencers on reconstruction rates were individual interactions in the healthcare system (54%), sociocultural environment (39%), behavioral factors (31%), and community interactions with the healthcare system (36%).
CONCLUSION: Racial disparities in postmastectomy breast reconstruction persist. Focusing on implicit bias, communication barriers and infrastructure are the most promising strategies to create equitable access to breast reconstruction for AA women.
Author List
Doren EL, Park K, Olson JAuthors
Erin L. Doren MD Associate Professor in the Plastic Surgery department at Medical College of WisconsinJessica Olson PhD Director, Assistant Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Breast NeoplasmsFemale
Healthcare Disparities
Humans
Mammaplasty
Mastectomy
Minority Health
Patient Protection and Affordable Care Act
United States
