{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:23:28Z","timestamp":1767677008258,"version":"build-2065373602"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine factors associated with hospital safety net burden and its impact on survival for patients with sinonasal squamous cell carcinoma (SNSCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective database study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National Cancer Database from 2004 to 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>SNSCC cases were identified in the National Cancer Database. Hospital safety net burden was defined by percentage of uninsured\/Medicaid patients treated, namely \u226425% for low\u2010burden hospitals, 26% to 75% for medium\u2010burden hospitals, and &gt;75% for high\u2010burden hospitals (HBHs). Univariate and multivariate analyses were used to investigate patient demographics, clinical characteristics, and overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An overall 6556 SNSCC cases were identified, with 1807 (27.6%) patients treated at low\u2010burden hospitals, 3314 (50.5%) at medium\u2010burden hospitals, and 1435 (21.9%) at HBHs. On multivariate analysis, Black race (odds ratio [OR], 1.39; 95% CI, 1.028\u20101.868), maxillary sinus primary site (OR, 1.31; 95% CI, 1.036\u20101.643), treatment at an academic\/research program (OR, 20.63; 95% CI, 8.868\u201047.980), and treatment at a higher\u2010volume facility (<jats:italic>P<\/jats:italic> &lt; .001) resulted in increased odds of being treated at HBHs. Patients with grade III\/IV tumor (OR, 0.70; 95% CI, 0.513\u20100.949), higher income (<jats:italic>P<\/jats:italic> &lt; .05), or treatment modalities other than surgery alone (<jats:italic>P<\/jats:italic> &lt; .05) had lower odds. Survival analysis showed that hospital safety net burden status was not significantly associated with overall survival (log\u2010rank <jats:italic>P<\/jats:italic> = .727).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with SNSCC, certain clinicopathologic factors, including Black race, lower income, treatment at an academic\/research program, and treatment at facilities in the West region, were associated with treatment at HBHs. Hospital safety net burden status was not associated with differences in overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998221099819","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T12:01:49Z","timestamp":1653393709000},"page":"413-421","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Hospital Safety Net Burden on Survival for Patients With Sinonasal Squamous Cell Carcinoma"],"prefix":"10.1002","volume":"168","author":[{"given":"Christopher C.","family":"Tseng","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeff","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory L.","family":"Barinsky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina H.","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery, Montefiore Medical Center The University Hospital of Albert Einstein College of Medicine Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordon G.","family":"Grube","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery Albany Medical Center Albany New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prayag","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne D.","family":"Hsueh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2893-7818","authenticated-orcid":false,"given":"Jean Anderson","family":"Eloy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA"},{"name":"Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey Rutgers New Jersey Medical School Newark New Jersey 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