Geographic Barriers Affect Follow‐Up Care in Head and Neck Cancer

Autor: Anand K. Devaiah, Jennifer N. Shehan, Heather A Edwards, Jessica LeClair, Judy J Wang, Pratima Agarwal, Tooba Alwani, Taylor F. Mahoney, Gregory A. Grillone, Salil T Chaudhry, Andrew Salama, Jacob P. Noordzij, Lauren F. Tracy, Scharukh Jalisi
Rok vydání: 2021
Předmět:
Zdroj: Laryngoscope
ISSN: 1531-4995
0023-852X
Popis: Objectives/hypothesis Follow-up care in head and neck cancers (HNC) is critical in managing patient health. However, social determinants of health (SDOH) can create difficulties in maintaining follow-up care. The study goal is to explore how SDOH impacts maintenance of HNC follow-up care appointments. Methods A systematic retrospective chart review of 877 HNC patients diagnosed in the past 10 years a safety-net tertiary care hospital with systems to help reduce care disparities. Cohort groups were identified and compared against protocols for follow-up. Data were analyzed using analysis of variance, chi-square tests, Fisher's exact tests, two-sample t-tests, and simple linear regression. Results The average length of follow-up time in months and average total number of follow-ups over 5 years were 32.96 (34.60) and 9.24 (7.87), respectively. There was no significant difference in follow-up care between United States (US) versus non-US born and English versus non-English speaking patients. Race/ethnicity, county median household income, insurance status, and county educational attainment were not associated with differences in follow-up. However, living a greater distance from the hospital was associated with lower follow-up length and less frequency in follow-up (P Conclusion While income, primary language, country of birth, race/ethnicity, insurance status, and markers of educational attainment do not appear to impact HNC follow-up at our safety-net, tertiary care institution, and distance from hospital remains an important contributor to disparities in care. This study shows that many barriers to care can be addressed in a model that addresses SDOH, but there are barriers that still require additional systems and resources. Laryngoscope, 2021.
Databáze: OpenAIRE
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