Race/Ethnicity and County-Level Social Vulnerability Impact Hospice Utilization Among Patients Undergoing Cancer Surgery

Abbas, Alizeh; Hyer, J. Madison; Pawlik, Timothy M.

doi:10.1245/s10434-020-09227-6

Cited by 32 publications

(27 citation statements)

References 50 publications

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“…Previous studies have identified increased risk of complications or death among minority patients with high social vulnerability based on the SVI who are undergoing surgical procedures such as colon resection or coronary artery bypass graft [ 25 ]. Cancer patients who were of a minority race had reduced odds of hospice utilization and early hospice initiation as their social vulnerability value increased [ 26 ]. This trend did not apply for cancer patients who were white [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cancer patients who were of a minority race had reduced odds of hospice utilization and early hospice initiation as their social vulnerability value increased [ 26 ]. This trend did not apply for cancer patients who were white [ 26 ]. The SVI offers a valuable metric for identifying patients who may be at risk for social determinants of health to profoundly affect their cancer care and outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Virtual visits among gynecologic oncology patients during the COVID-19 pandemic are accessible across the social vulnerability spectrum

McAlarnen

Tsaih

Aliani

et al. 2021

Gynecologic Oncology

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Objective The COVID-19 pandemic has quickly transformed healthcare systems with expansion of telemedicine. The past year has highlighted risks to immunosuppressed cancer patients and shown the need for health equity among vulnerable groups. In this study, we describe the utilization of virtual visits by patients with gynecologic malignancies and assess their social vulnerability. Methods Virtual visit data of 270 gynecology oncology patients at a single institution from March 1, 2020 to August 31, 2020 was obtained by querying a cohort discovery tool. Through geocoding, the CDC Social Vulnerability Index (SVI) was utilized to assign social vulnerability indices to each patient and the results were analyzed for trends and statistical significance. Results African American patients were the most vulnerable with a median SVI of 0.71, Asian 0.60, Hispanic 0.41, and Caucasian 0.21. Eighty-seven percent of patients in this study were Caucasian, 8.9% African American, 3.3% Hispanic, and 1.1% Asian, which is comparable to the baseline institutional gynecologic cancer population. The mean census tract SVI variable when comparing patients to all census tracts in the United States was 0.31 (range 0.00 least vulnerable to 0.98 most vulnerable). Conclusions Virtual visits were utilized by patients of all ages and gynecologic cancer types. African Americans were the most socially vulnerable patients of the cohort. Telemedicine is a useful platform for cancer care across the social vulnerability spectrum during the pandemic and beyond. To ensure continued access, further research and outreach efforts are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Virtual visits among gynecologic oncology patients during the COVID-19 pandemic are accessible across the social vulnerability spectrum

McAlarnen

Tsaih

Aliani

et al. 2021

Gynecologic Oncology

View full text Add to dashboard Cite

show abstract

“…For this analysis, a weighted SVI corresponding to the zip code of the patient's current address was derived with steps and is provided as Supplemental Digital Content 1 for this article, published at http://links.lww.com/JHM/A72. Although the SVI has only been validated as a predictive measure of damages and fatalities after a natural disaster (Bakkensen et al, 2017), it has also been used to examine health outcomes such as obesity (An & Xiang, 2015) and hospice utilization (Abbas et al, 2020). To the best of our knowledge, no studies have used the CDC's SVI as a measure of social vulnerability that may influence healthcare use.…”

Section: Predictor Of Interestmentioning

confidence: 99%

Medical Complexity Mediates Healthcare Resource Use in the Socially Vulnerable

Hanlon¹,

Pauly²,

Huang³

et al. 2022

Journal of Healthcare Management

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Goal:The objective of this retrospective, observational study was to assess the mediating effect of medical complexity on the relationship between social vulnerability and four acute care resource use outcomes-number of hospitalizations, emergency department (ED) visits, observation stays, and total visits. Such information may help healthcare managers better anticipate the effects of interventions targeted to the socially vulnerable in their patient population.Methods: Electronic health records of 147,496 adults served by 27 primary care practices in one large health system from 2015 to 2017 were used. Descriptive statistics were applied to characterize patients and the primary care practices included in the study. Causal mediation analyses using a modified Baron and Kenny approach were performed.Principal Findings: Causal mediation analyses demonstrated that increased social vulnerability was associated with increased medical complexity (incidence rate ratio [IRR] = 1.57) and increased numbers of hospitalizations (IRR = 1.63), ED visits (IRR = 2.14), observation stays (IRR = 1.94), and total visits (IRR = 2.04). Effects remained significant, though attenuated, after adjusting for medical complexity (mediator), demographics, and medications (hospitalizations IRR = 1.44, ED visits IRR = 2.02, observation stays IRR = 1.74, total visits

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“… 7 Simultaneously, disparities in access to hospice services have been identified among patients undergoing surgery. 8 , 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

“…However, the literature in this domain is in its nascency, and gaps in our understanding of patients undergoing surgery who enroll in hospice remain. 9 In particular, how patients within different surgical specialties use hospice services, which particular patients benefit from these services, and what resources are used after hospice enrollment are unknown. To begin to address these gaps, we aimed to characterize patients who transition to hospice after gastrointestinal tract surgery in acute care hospitals using a statewide database, quantify the associated use of resources, and identify areas of hospice transition that warrant further attention and intervention.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Procedures Among Adults Discharged to Hospice After Gastrointestinal Tract Surgery in California

et al. 2022

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IMPORTANCE Hospice care is associated with improved quality of life and goal-concordant care.Limited data suggest that provision of hospice services after surgery is suboptimal; however, literature in this domain is in its nascency, leaving gaps in our understanding of patients who enroll in hospice after surgery.OBJECTIVE To characterize the transition to hospice after gastrointestinal tract surgery and identify areas that warrant further attention and intervention. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study included patients discharged to hospice after a surgical hospitalization for a digestive disorder in California-licensed

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Race/Ethnicity and County-Level Social Vulnerability Impact Hospice Utilization Among Patients Undergoing Cancer Surgery

Cited by 32 publications

References 50 publications

Virtual visits among gynecologic oncology patients during the COVID-19 pandemic are accessible across the social vulnerability spectrum

Virtual visits among gynecologic oncology patients during the COVID-19 pandemic are accessible across the social vulnerability spectrum

Medical Complexity Mediates Healthcare Resource Use in the Socially Vulnerable

Characteristics and Procedures Among Adults Discharged to Hospice After Gastrointestinal Tract Surgery in California

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