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Published on: May 17, 2019
A Comprehensive Analysis of Unmet Social Needs in Breast Cancer Patients Treated at an Academic Cancer Center and
Maya Lubarsky1,2, Alexandra E Hernandez3,2, Peter A Borowsky3,2
1Department of Internal Medicine, Case Western Reserve University Hospitals, Cleveland, OH, USA.
Background:
Social needs are direct mediators of poor health outcomes. They are actionable targets for physicians and healthcare systems to address. The goal of this study was to evaluate the presence of unmet social needs in breast cancer patients at an NCI-designated academic cancer center (ACC) and its sister safety-net hospital (SNH).
Methods:
Prospective cohort study of 336 patients with diagnosed breast cancer administered the Health Leads Social Needs Screening Toolkit. Patient demographics, risk factors, tumor characteristics, and stage-appropriate treatment were analyzed by using chi-square tests and analysis of variance (ANOVA).
Results:
42% of patients presented to either hospital with one or more unmet social needs. The SNH patients were more likely to present with two or more unmet social needs compared to ACC patients (32% vs. 17%, p = .023), while ACC patients were more likely to present with zero or one unmet social needs compared to SNH patients (61% vs. 47.8% and 22% vs. 20%, respectively, p = .023). The most reported unmet social needs was a Lack of Companionship (17%). Patients who presented to SNH compared with ACC were more likely to report unmet social needs in the domains of Food Insecurity (20% vs. 8%, p = .003), Housing (25% vs. 14%, p = .024), Healthcare Costs (16% vs. 6%, p = .007), and Transportation (17% vs. 5%, p < .001).
Discussion:
There are significant differences in the presence of unmet social needs in patients who present to different hospital systems. Support systems which address these unmet social needs are important to improve breast cancer health outcomes.
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