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To determine whether various individual factors such as patient demographics and various community factors such as characteristics of the neighborhood in which the patient lives would influence access to immediate breast reconstruction.

Multilevel analysis of the Maryland Hospital Discharge Database, a prospectively collected observational database of inpatient care for all hospitals in Maryland.

Database analysis.

We queried forInternational Classification of Diseases, Ninth Revisionprocedure codes for all patients undergoing mastectomy and reconstruction during the same hospitalization in Maryland from January 1, 1995, through December 31, 2004.

Disparities in immediate reconstruction rates via analysis of the impact of patient-level and community-level factors.

A total of 18 690 patients underwent mastectomy in Maryland during the study …