ArticlePloS one2016
Differences in Breast Cancer Survival between Public and Private Care in New Zealand: Which Factors Contribute?
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 30 citations in OpenAlex.
- Disparities in time to breast cancer surgery in New Zealand by level of neighbourhood deprivation: a population-based study.Cancer causes & control : CCC · 2025Article
- Ethnic differences in time to surgery for women with early stage breast cancer in Aotearoa/New Zealand: a population-based study.The Lancet regional health. Western Pacific · 2024Article
- Ethnic inequities in use of breast conserving surgery and radiation therapy in Aotearoa/New Zealand: which factors contribute?Breast cancer research and treatment · 2024Article
- Observational
- Associated Factors and Survival Outcomes for Breast Conserving Surgery versus Mastectomy among New Zealand Women with Early-Stage Breast Cancer.International journal of environmental research and public health · 2021Article
- The changing landscape of vestibular schwannoma diagnosis and management: A cross-sectional study.The Laryngoscope · 2020Article
- How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia.PloS one · 2019Article
- Development and validation of a new predictive model for breast cancer survival in New Zealand and comparison to the Nottingham prognostic index.BMC cancer · 2018Article
- Ethnic disparities in breast cancer survival in New Zealand: which factors contribute?BMC cancer · 2018Article
- Disparities in Non-Fatal Health Outcomes in Pediatric General Trauma Studies.International journal of environmental research and public health · 2017Review
- Advanced Stage at Presentation Remains a Major Factor Contributing to Breast Cancer Survival Disparity between Public and Private Hospitals in a Middle-Income Country.International journal of environmental research and public health · 2017Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients who received private health care appear to have better survival from breast cancer compared to those who received public care. This study investigated if this applied to New Zealand women and identified factors that could explain such disparities.
methodsThis study involved all women who were diagnosed with primary breast cancer in two health regions in New Zealand, covering about 40% of the national population, between June 2000 and May 2013. Patients who received public care for primary treatment, mostly surgical treatment, were compared with those who received private care in terms of demographics, mode of presentation, disease factors, comorbidity index and treatment factors. Cox regression modelling was performed with stepwise adjustments, and hazards of breast cancer specific mortality associated with the type of health care received was assessed.
resultsOf the 14,468 patients, 8,916 (61.6%) received public care. Compared to patients treated in private care facilities, they were older, more likely to be Māori, Pacifika or Asian and to reside in deprived neighbourhoods and rural areas, and less likely to be diagnosed with early staged cancer and to receive timely cancer treatments. They had a higher risk of mortality from breast cancer (hazard ratio: 1.95; 95% CI: 1.75, 2.17), of which 80% (95% CI: 63%, 100%) was explained by baseline differences, particularly related to ethnicity, stage at diagnosis and type of loco-regional therapy. After controlling for these demographic, disease and treatment factors, the risk of mortality was still 14% higher in the public sector patients.
conclusionsEthnicity, stage at diagnosis and type of loco-regional therapy were the three key contributors to survival disparities between patients treated in public and private health care facilities in New Zealand. The findings underscore the need for more efforts to improve the quality, timeliness and equitability of public cancer care services.
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