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Health Care Access Measures and Palliative Care Use by Race/Ethnicity among Metastatic Gynecological Cancer Patients in the United States.

Publication ,  Journal Article
Islam, JY; Saraiya, V; Previs, RA; Akinyemiju, T
Published in: Int J Environ Res Public Health
June 4, 2021

Palliative care improves quality-of-life and extends survival, however, is underutilized among gynecological cancer patients in the United States (U.S.). Our objective was to evaluate associations between healthcare access (HCA) measures and palliative care utilization among U.S. gynecological cancer patients overall and by race/ethnicity. We used 2004-2016 data from the U.S. National Cancer Database and included patients with metastatic (stage III-IV at-diagnosis) ovarian, cervical, and uterine cancer (n = 176,899). Palliative care was defined as non-curative treatment and could include surgery, radiation, chemotherapy, and pain management, or any combination. HCA measures included insurance type, area-level socioeconomic measures, distance-to-care, and cancer treatment facility type. We evaluated associations of HCA measures with palliative care use overall and by race/ethnicity using multivariable logistic regression. Our population was mostly non-Hispanic White (72%), had ovarian cancer (72%), and 24% survived <6 months. Five percent of metastatic gynecological cancer patients utilized palliative care. Compared to those with private insurance, uninsured patients with ovarian (aOR: 1.80,95% CI: 1.53-2.12), and cervical (aOR: 1.45,95% CI: 1.26-1.67) cancer were more likely to use palliative care. Patients with ovarian (aOR: 0.58,95% CI: 0.48-0.70) or cervical cancer (aOR: 0.74,95% CI: 0.60-0.88) who reside >45 miles from their provider were less likely to utilize palliative care than those within <2 miles. Ovarian cancer patients treated at academic/research programs were less likely to utilize palliative care compared to those treated at community cancer programs (aOR: 0.70, 95%CI: 0.58-0.84). Associations between HCA measures and palliative care utilization were largely consistent across U.S. racial-ethnic groups. Insurance type, cancer treatment facility type, and distance-to-care may influence palliative care use among metastatic gynecological cancer patients in the U.S.

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Published In

Int J Environ Res Public Health

DOI

EISSN

1660-4601

Publication Date

June 4, 2021

Volume

18

Issue

11

Location

Switzerland

Related Subject Headings

  • United States
  • Toxicology
  • Palliative Care
  • Neoplasms
  • Medically Uninsured
  • Humans
  • Hispanic or Latino
  • Healthcare Disparities
  • Health Services Accessibility
  • Ethnicity
 

Citation

APA
Chicago
ICMJE
MLA
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Islam, J. Y., Saraiya, V., Previs, R. A., & Akinyemiju, T. (2021). Health Care Access Measures and Palliative Care Use by Race/Ethnicity among Metastatic Gynecological Cancer Patients in the United States. Int J Environ Res Public Health, 18(11). https://doi.org/10.3390/ijerph18116040
Islam, Jessica Y., Veeral Saraiya, Rebecca A. Previs, and Tomi Akinyemiju. “Health Care Access Measures and Palliative Care Use by Race/Ethnicity among Metastatic Gynecological Cancer Patients in the United States.Int J Environ Res Public Health 18, no. 11 (June 4, 2021). https://doi.org/10.3390/ijerph18116040.
Islam JY, Saraiya V, Previs RA, Akinyemiju T. Health Care Access Measures and Palliative Care Use by Race/Ethnicity among Metastatic Gynecological Cancer Patients in the United States. Int J Environ Res Public Health. 2021 Jun 4;18(11).
Islam, Jessica Y., et al. “Health Care Access Measures and Palliative Care Use by Race/Ethnicity among Metastatic Gynecological Cancer Patients in the United States.Int J Environ Res Public Health, vol. 18, no. 11, June 2021. Pubmed, doi:10.3390/ijerph18116040.
Islam JY, Saraiya V, Previs RA, Akinyemiju T. Health Care Access Measures and Palliative Care Use by Race/Ethnicity among Metastatic Gynecological Cancer Patients in the United States. Int J Environ Res Public Health. 2021 Jun 4;18(11).

Published In

Int J Environ Res Public Health

DOI

EISSN

1660-4601

Publication Date

June 4, 2021

Volume

18

Issue

11

Location

Switzerland

Related Subject Headings

  • United States
  • Toxicology
  • Palliative Care
  • Neoplasms
  • Medically Uninsured
  • Humans
  • Hispanic or Latino
  • Healthcare Disparities
  • Health Services Accessibility
  • Ethnicity