Predicting No Show in Voice therapy: Avoiding the Missed Appointment Cycle

Vamosi, Briana E.; Mikhail, Lauren; Gustin, Renée L.; Pielage, Kathryn C; Reid, Katelyn; Tabangin, Meredith E.; Altaye, Mekibib; Collar, Ryan M.; Khosla, Sid; Giliberto, John Paul; Howell, Rebecca J.

doi:10.1016/j.jvoice.2020.01.003

Cited by 14 publications

(8 citation statements)

References 7 publications

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“…Black patients received more nonsurgical interventions (observation or voice therapy) compared to White patients. Vamosi et al reported that nonwhite patient groups were associated with higher no‐show rates in voice therapy likely due to transportation availability and differences in income and education 22 . A previous study from our group found areas with the highest Black populations in our care network had lower median income and education levels and correspondingly lower utilization rates for tertiary rhinology services 23 .…”

Section: Discussionmentioning

confidence: 68%

Demographic differences in the treatment of unilateral vocal fold paralysis

Patel

Bock

Blumin

et al. 2022

Laryngoscope Investig Oto

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Objective: To determine the impact of patient demographics and social determinants of health on treatment pathways for unilateral vocal fold paralysis (UVFP) at a tertiary laryngology clinic.Study design: Retrospective medical record review.Methods: Patient demographics (age, gender, race, ethnicity, and insurance status) were extracted for adults diagnosed with UVFP between 2009 and 2019. Odds ratios for the associations between sociodemographic factors and UVFP treatment pathways were determined by chi-square analyses.Results: A total of 1490 UVFP diagnoses were identified during the study period with the majority being female (58%), White (85%), non-Hispanic (97%), and publicly insured (54%). Five treatment pathways were identified: observation, injection laryngoplasty, voice therapy, laryngeal framework surgery/thyroplasty, and reinnervation surgery. There were 538 patients who underwent observation, 512 injection laryngoplasty, 366 voice therapy, 136 thyroplasty, and 26 laryngeal reinnervation surgery.Males were more likely to undergo injection laryngoplasty than females (OR 1.32; CI 1.08-1.61), whereas females were more likely to undergo voice therapy (OR 1.39; CI 1.09-1.76). Patients with public insurance (OR 1.48; CI 1.03-2.14) and Hispanics (OR 2.60; CI 1.18-5.72) were more likely to undergo thyroplasty. Patients who underwent reinnervation surgery were younger than those in other treatment pathways (median: 39.1 years vs. 50.7-56.1 years).Conclusions: Gender, ethnicity, and insurance status were significantly associated with specific UVFP treatment pathways. Patients with public insurance were more likely to undergo surgical intervention than voice therapy. This data overall supports differences in care pathway utilization for UVFP based on social determinants of health.

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Section: Discussionmentioning

confidence: 68%

Demographic differences in the treatment of unilateral vocal fold paralysis

Patel

Bock

Blumin

et al. 2022

Laryngoscope Investig Oto

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“…Race/ethnicity‐related disparities elucidated include minorities having a lower odds of reporting a voice disorder 58 and being less likely to seek out and attend voice therapy 63,64 . In a retrospective review of 146 patients referred for voice therapy, Vamosi et al found that non‐white race was significantly associated with no‐show status (χ 2 = 9.4576, P = .002) 63 .…”

Section: Resultsmentioning

confidence: 99%

“…58 Non-white race associated with higher voice therapy no-show rate (χ 2 = 11.76, P = .0006). 63 Non-Hispanics (78% attendance) vs. Hispanics (57%) more adherent to voice therapy for benign vocal fold nodules (P = .025). 64 Sex/gender Males less likely to report voice disorders.…”

Section: Educationmentioning

confidence: 99%

“…60 Race/ethnicity-related disparities elucidated include minorities having a lower odds of reporting a voice disorder 58 and being less likely to seek out and attend voice therapy. 63,64 In a retrospective review of 146 patients referred for voice therapy, Vamosi et al found that nonwhite race was significantly associated with no-show status (χ 2 = 9.4576, P = .002). 63 Surprisingly, despite the special importance of voice care to the transgender and nonbinary/genderqueer community, no studies examined unequal access, quality of services, or outcomes in this population.…”

Section: Voice Disordersmentioning

confidence: 99%

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Healthcare Disparities in Laryngology: A Scoping Review

et al. 2020

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Objectives/Hypothesis: This scoping review aims to map out existing disparities research within the subspecialty of laryngology in order to highlight gaps in knowledge and guide future research.Study Design: Scoping Review.Methods: We completed a scoping review of PubMed, Ovid Embase, and the Cochrane Library for primary research focused on evaluating the existence and impact of disparities in race/ethnicity, sex/gender, insurance status, education level, income, geography, and LGBTQ identity in the context of various laryngological conditions. Publications of any design and date, performed in the United States, and focusing on the adult population exclusively were included.Results: Of the 4,999 unique abstracts identified, 51 articles were ultimately included. The most frequently examined condition in relation to disparities was laryngeal cancer (27 of 51), followed by voice disorders (15 of 51), deglutitive disorders (eight of 51), and airway disorders (one of 51). Sources of inequity evaluated from most common to least common were race/ethnicity (43 of 51), sex/gender (39 of 51), insurance status (23 of 51), geography (23 of 51), income (21 of 51), and education level (16 of 51). No study examined the association of LGBTQ identity with inequity.Conclusions: This scoping review highlights the limited extent of disparities research in laryngology and establishes the need for further scholarship on the impact of disparities in laryngology care. The pathologies studied were, in decreasing order of frequency: laryngeal cancer, voice disorders, deglutitive disorders, and airway disorders. Race/ethnicity and sex/gender were the most common disparities examined, with no evaluation of LGBTQ-related care inequity.

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“…Health disparities among patients with voice, 7–13 swallowing, 14–19 or airway concerns 20 have been described in the literature. These articles served to identify the impact of race/ethnicity, sex/gender, and various socioeconomic factors in relation to their burden of disease, access to care, offered treatment modalities, and outcomes.…”

Section: Introductionmentioning

confidence: 99%

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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Predicting No Show in Voice therapy: Avoiding the Missed Appointment Cycle

Cited by 14 publications

References 7 publications

Demographic differences in the treatment of unilateral vocal fold paralysis

Demographic differences in the treatment of unilateral vocal fold paralysis

Healthcare Disparities in Laryngology: A Scoping Review

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

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