Access to primary care is associated with better XXXX outcomes in an urban county hospital.

@entity1 @entity82 @entity3619 @entity204 @entity775
BACKGROUND: @entity775 causes @entity3619 and often leads to @entity82 and @entity204 without treatment. We wanted to see if having access to primary care or insurance prior to diagnosis is associated with better outcomes for @entity1 in an urban, public hospital with mostly socioeconomically disadvantaged Hispanic @entity1 . METHODS: We did a retrospective study at our institution. Kaplan Meier survival analysis was done looking at transplant-free overall survival for @entity1 diagnosed at our institution. The log-rank test was done to compare survival between @entity1 with and without prior access to primary care, and between @entity1 with and without insurance at diagnosis. RESULTS: Overall 5- and 10-year transplant-free overall survival was 91  % (95  % CI, 83-100  %) and 75  % (95  % CI, 50-99  %), respectively. @entity1 with primary care prior to diagnosis had significantly better transplant-free overall survival than those without (log rank test p   =   0.019). @entity1 with primary care also had better clinical markers at diagnosis. Having insurance at diagnosis was not associated with better outcomes. CONCLUSIONS: Outcomes of @entity775 are poor in our setting but access to primary care prior to diagnosis was associated with better outcomes. This is likely due to the important role that primary care plays in detecting disease and initiating treatment earlier. With the expansion of access to healthcare that the Affordable Care Act provides, future @entity1 are likely to do better with even rare diseases like @entity775 .
