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Geographic Barriers Affect Follow-Up Care in Head and Neck Cancer
Tooba Alwani1, Jennifer N Shehan2, Jessica LeClair3
1Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, U.S.A.
The Laryngoscope
|November 11, 2021
Summary
Social determinants of health (SDOH) impact head and neck cancer (HNC) follow-up. While many factors like income and race did not show differences, distance from the hospital significantly affected patient follow-up care.
Area of Science:
- Oncology
- Public Health
- Health Services Research
Background:
- Follow-up care is crucial for head and neck cancer (HNC) patients.
- Social determinants of health (SDOH) can impede consistent follow-up.
- Understanding these barriers is key to improving patient outcomes.
Purpose of the Study:
- To investigate the impact of SDOH on head and neck cancer follow-up care appointment maintenance.
- To identify specific SDOH factors that influence adherence to follow-up protocols.
Main Methods:
- A retrospective chart review of 877 HNC patients at a safety-net tertiary care hospital.
- Comparison of follow-up care against established protocols.
- Statistical analysis including ANOVA, chi-square, Fisher's exact, t-tests, and regression.
Main Results:
- No significant differences in follow-up based on country of birth or language.
- Race/ethnicity, income, insurance, and education levels were not associated with follow-up disparities.
- Increased distance from the hospital was significantly linked to reduced follow-up length and frequency (P < .0001).
Conclusions:
- While many SDOH factors like income and race did not impact follow-up at this institution, geographic distance remains a significant barrier.
- Addressing SDOH can mitigate some care disparities, but additional systemic resources are needed.
- Targeted interventions for geographically distant patients are essential for equitable HNC care.
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