Healthcare Disparities in Laryngology: A Scoping Review

Feit, Noah Z.; Wang, Zhaorui; Demetres, Michelle; Drenis, Sotirios; Andreadis, Katerina; Rameau, Anaïs

doi:10.1002/lary.29325

Cited by 50 publications

(38 citation statements)

References 81 publications

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“…No information on sexual orientation or gender identity was able to be collected from our data set, which is greatly problematic particularly in the transgender and nonbinary/genderqueer populations seeking care from a laryngology treatment team. Since voice is inherently important to gender identity, further studies are necessary to identify inequities in laryngological care as called to action on other manuscripts 21 …”

Section: Discussionmentioning

confidence: 99%

“…Since voice is inherently important to gender identity, further studies are necessary to identify inequities in laryngological care as called to action on other manuscripts. 21…”

Section: Discussionmentioning

confidence: 99%

“…Feit et al performed a scoping review identifying disparities in research within the subspecialty of laryngology 21 . This included many of the previously cited articles and demonstrated a significant need for further research focusing on disparities and their impacts on laryngological care.…”

Section: Introductionmentioning

confidence: 99%

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The Demographics of Patients Presenting for Laryngological Care at an Academic Medical Center

et al. 2021

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Objectives/Hypothesis Few studies address the demographics/epidemiology/socioeconomic status of patients presenting to a laryngologist at a tertiary care center for treatment. To identify any possible disparities in voice, airway, and swallowing care, we sought to analyze the aforementioned data for new patients presenting to the voice center at an academic medical center. Methods This is a retrospective cohort study of prospectively collected data from an institutional database of 4,623 new adult patients presenting for laryngological care at a tertiary care, academic medical center from 2015 to 2020. Demographic data were analyzed. Results Of 4,623 patients, 62.8% were female and 37.2% were male with ages ranging from 19 to 99 years (Avg 59.51, standard deviation 15.83). Patients were 81.8% white, 13% black, and 5.2% other, compared with 56.3% white, 34.8% black, 20% other in the local municipality from US Census Data. Payer mix included 46.98% Medicare, 42.59% commercial insurance, 3.22% Medicaid, 5.19% other, and 2.01% uninsured/self‐insured. Patient demographics based on primary diagnosis codes were also examined. A majority of patients presented with voice‐related complaints. Conclusions Understanding the demographics of those with laryngological disorders will help to develop targeted interventions and effective outreach programs for underrepresented patient populations. Future multicenter studies could provide further insight into the distribution of healthcare disparities in laryngology. Level of Evidence 3 Laryngoscope, 132:626–632, 2022

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Section: Discussionmentioning

confidence: 99%

“…Since voice is inherently important to gender identity, further studies are necessary to identify inequities in laryngological care as called to action on other manuscripts. 21…”

Section: Discussionmentioning

confidence: 99%

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The Demographics of Patients Presenting for Laryngological Care at an Academic Medical Center

et al. 2021

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“…Inclusion criteria were studies that (1) assessed PRO implementation in routine clinical care, (2) had a specific and explicit aim of studying PRO implementation in diverse or underrepresented populations, such as racial or ethnic minorities, sexual and gender minorities, elderly or geriatric populations ≥ 65 years of age, and populations with diverse literacy, educational, socioeconomic or geographic (rural or urban) status, (3) used a validated PROM, and (4) English language. Studies were limited to those conducted in the United States because diverse and underrepresented populations are in part defined by the specific historical, economic, and cultural contexts of their country of origin, as detailed in a previously published review [ 30 ]. In addition, certain sociodemographic factors such as insurance status and results concerning routine clinical care and PRO collection would be more generalizable to the unique healthcare system within the United States.…”

Section: Methodsmentioning

confidence: 99%

Implementing patient-reported outcomes in routine clinical care for diverse and underrepresented patients in the United States

Hyland

Guo

Dhawan

et al. 2022

J Patient Rep Outcomes

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Background Patient-reported outcomes (PROs) are used increasingly in routine clinical care and inform policies, reimbursements, and quality improvement. Less is known regarding PRO implementation in routine clinical care for diverse and underrepresented patient populations. Objective This review aims to identify studies of PRO implementation in diverse and underrepresented patient populations, elucidate representation of clinical specialties, assess implementation outcomes, and synthesize patient needs, concerns, and preferences. Methods MEDLINE, Embase, Web of Science, CINAHL, and PsycINFO were searched September 2021 for studies aiming to study PRO implementation in diverse and underrepresented patient populations within the United States. Studies were screened and data extracted by three independent reviewers. Implementation outcomes were assessed according to Proctor et al. taxonomy. A descriptive analysis of data was conducted. Results The search yielded 8,687 records, and 28 studies met inclusion criteria. The majority were observational cohort studies (n = 21, 75%) and conducted in primary care (n = 10, 36%). Most studies included majority female (n = 19, 68%) and non-White populations (n = 15, 54%), while fewer reported socioeconomic (n = 11, 39%) or insurance status (n = 9, 32.1%). Most studies assessed implementation outcomes of feasibility (n = 27, 96%) and acceptability (n = 19, 68%); costs (n = 3, 11%), penetration (n = 1, 4%), and sustainability (n = 1, 4%) were infrequently assessed. Conclusion PRO implementation in routine clinical care for diverse and underrepresented patient populations is generally feasible and acceptable. Research is lacking in key clinical specialties. Further work is needed to understand how health disparities drive PRO implementation outcomes.

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“…Social determinants of health (SDOHs) as defined by the Centers for Disease Control and Prevention (CDC), are the “conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes.” 1 The effects of SDOHs on health care have been increasingly recognized in recent literature. Within otolaryngology, scoping and systematic reviews have characterized health care disparities in pediatric otolaryngology, 2,3 head and neck cancer, 4-6 rhinology, 7-9 laryngology, 10 and otology. 11-13 While studies on socioeconomic status, education, and ethnic disparities are relatively well represented, rurality is often left out of these reviews completely 3-9,11 or only narrowly addressed.…”

mentioning

confidence: 99%

Rural Otolaryngology Care Disparities: A Scoping Review

Urban

Shimomura

Shah

et al. 2022

Otolaryngol.--head neck surg.

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Objective To broadly synthesize the literature regarding rural health disparities in otolaryngology, categorize findings, and identify research gaps to stimulate future work. Study Design Scoping review. Data Sources A comprehensive literature search was performed in the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar, and CINAHL. Review Methods The methods were developed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Peer-reviewed, English-language, US-based studies examining a rural disparity in otolaryngology-related disease incidence, prevalence, diagnosis, treatment, or outcome were included. Descriptive studies, commentaries, reviews, and letters to the editor were excluded. Studies published prior to 1980 were excluded. Results The literature search resulted in 1536 unique abstracts and yielded 79 studies that met final criteria for inclusion. Seventy-five percent were published after 2010. The distribution of literature was as follows: otology (34.2%), head and neck cancer (20.3%), endocrine surgery (13.9%), rhinology and allergy (8.9%), trauma (5.1%), laryngology (3.8%), other pediatrics (2.5%), and adult sleep (1.3%). Studies on otolaryngology health care systems also accounted for 10.1%. The most common topics studied were practice patterns (41%) and epidemiology (27%), while the Southeast (47%) was the most common US region represented, and database study (42%) was the most common study design. Conclusion Overall, there was low-quality evidence with large gaps in the literature in all subspecialties, most notably facial plastic surgery, laryngology, adult sleep, and pediatrics. Importantly, there were few studies on intervention and zero studies on resident exposure to rural populations, which will be critical to making rural otolaryngology care more equitable in the future.

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Healthcare Disparities in Laryngology: A Scoping Review

Cited by 50 publications

References 81 publications

The Demographics of Patients Presenting for Laryngological Care at an Academic Medical Center

The Demographics of Patients Presenting for Laryngological Care at an Academic Medical Center

Implementing patient-reported outcomes in routine clinical care for diverse and underrepresented patients in the United States

Rural Otolaryngology Care Disparities: A Scoping Review

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