Exploring the effects of racial and socioeconomic factors on timeliness of lung cancer diagnosis and treatment in Baltimore Veterans.

OBJECTIVES: To characterize the effect of racial and socioeconomic factors on the timeliness of lung cancer diagnosis and treatment in a single-center Veterans Affair Medical Center (VAMC) pulmonary nodule clinic. METHODS: We conducted a single-center retrospective review of all patients seen at the Baltimore VAMC pulmonary nodule clinic between 2013 and 2019 to identify key demographic factors, measures of neighborhood socioeconomic disadvantage, cancer staging and histopathologic information, and time elapsed between diagnosis and treatment. We excluded patients with pulmonary nodules undergoing active surveillance, prior history of lung cancer, metastases of a different primary origin, insufficient followup, or who had received care outside the VHA system. RESULTS: Median times to diagnosis and treatment of lung cancer were 28 and 73 days. There were no statistically significant differences in overall timeliness of diagnosis and treatment when stratified by race or measures of neighborhood socioeconomic disadvantage. CONCLUSIONS: The authors found no differences in timeliness of lung cancer care by race and socioeconomic status within the system. Despite general adherence to national standards in timeliness of care, there continues to be a need for improvements in the operational workflows to reduce time to diagnosis and treatment for all Veterans.

Obesity as a Risk Factor for Urinary Tract Infection in Children.

Childhood obesity is a nationwide epidemic with an estimated 16% to 18% of children and adolescents qualifying as obese and another 21% to 24% considered overweight. Obesity has been linked to an increased risk of developing serious infections. Healthcare Cost and Utilization Project-Kids' Inpatient Database 2009 was queried to analyze national trends in patient encounters, specifically those listing patients as comorbid obese and then identified those with urinary tract infection (UTI) as primary or secondary diagnosis. Propensity matching was used to calculate risk for UTI in the inpatient obese pediatric population. A total of 86 638 pediatric hospital admissions were enrolled in the study of which 41 819 included the diagnosis of obesity, and a UTI was diagnosed in 2445 of the cases. In a propensity-matched sample, matched for age, sex, race, and diabetes mellitus, the risk of UTI was increased by 45% in obese females. Obese males did not have a significantly increased risk for UTI.