Date of Award

3-20-2026

Embargo Period

5-16-2026

Document Type

Dissertation - MUSC Only

Degree Name

Doctor of Health Administration

Department

Health Administration

College

College of Health Professions

First Advisor

Daniel Brinton

Second Advisor

Susana Campos

Third Advisor

Kevin Wiley

Abstract

Ovarian cancer is one of the deadliest gynecologic malignancies, and timely surgical intervention is critical to improving survival outcomes. This retrospective observational study examined whether time from initial diagnosis to definitive surgery varied by age group, geographic region, and financial burden among commercially insured women aged 45–65 in the United States. Using 2021–2023 MarketScan commercial claims data, 540 women with newly diagnosed primary ovarian cancer who underwent definitive surgery were analyzed. Generalized linear models assessed the associations between time to surgery and age (45–54 vs. 55–65), geographic region, and out-of-pocket costs, adjusting for comorbidity burden and insurance type.

Results demonstrated no statistically significant differences in time to surgery by age group or geographic region after adjustment. However, out-of-pocket costs were significantly associated with time from initial diagnosis to definitive surgery. Patients with lower out-of-pocket costs experienced longer time-to-treatment intervals compared to those with higher financial responsibility. These findings suggest that financial and structural factors, including insurance-related processes, may influence timeliness of care more than demographic characteristics within a commercially insured population.

Understanding how financial burden affects access to timely ovarian cancer surgery may inform targeted policy and system-level interventions to improve care delivery and reduce disparities.

Rights

Copyright is held by the author. All rights reserved.

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Available for download on Saturday, May 16, 2026

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