Modifiers of and Disparities in Palliative and Supportive Care Timing and Utilization among Neurosurgical Patients with Malignant Central Nervous System Tumors
Patients with primary or secondary central nervous system (CNS) malignancies benefit from utilization of palliative care (PC) in addition to other supportive services, such as home health and social work. Guidelines propose early initiation of PC for patients with advanced cancers. We analyzed a coh...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/10/2567 |
| _version_ | 1797501000591867904 |
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| author | Michael Chuwei Jin Gary Hsin John Ratliff Reena Thomas Corinna Clio Zygourakis Gordon Li Adela Wu |
| author_facet | Michael Chuwei Jin Gary Hsin John Ratliff Reena Thomas Corinna Clio Zygourakis Gordon Li Adela Wu |
| author_sort | Michael Chuwei Jin |
| collection | DOAJ |
| description | Patients with primary or secondary central nervous system (CNS) malignancies benefit from utilization of palliative care (PC) in addition to other supportive services, such as home health and social work. Guidelines propose early initiation of PC for patients with advanced cancers. We analyzed a cohort of privately insured patients with malignant brain or spinal tumors derived from the Optum Clinformatics Datamart Database to investigate health disparities in access to and utilization of supportive services. We introduce a novel construct, “provider patient racial diversity index” (provider pRDI), which is a measure of the proportion of non-white minority patients a provider encounters to approximate a provider’s patient demographics and suggest a provider’s cultural sensitivity and exposure to diversity. Our analysis demonstrates low rates of PC, home health, and social work services among racial minority patients. Notably, Hispanic patients had low likelihood of engaging with all three categories of supportive services. However, patients who saw providers categorized into high provider pRDI (categories II and III) were increasingly more likely to interface with supportive care services and at an earlier point in their disease courses. This study suggests that prospective studies that examine potential interventions at the provider level, including diversity training, are needed. |
| first_indexed | 2024-03-10T03:11:58Z |
| format | Article |
| id | doaj.art-d4c6bcf4d0c14ab4b4cc9e0083a07670 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T03:11:58Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-d4c6bcf4d0c14ab4b4cc9e0083a076702023-11-23T10:25:00ZengMDPI AGCancers2072-66942022-05-011410256710.3390/cancers14102567Modifiers of and Disparities in Palliative and Supportive Care Timing and Utilization among Neurosurgical Patients with Malignant Central Nervous System TumorsMichael Chuwei Jin0Gary Hsin1John Ratliff2Reena Thomas3Corinna Clio Zygourakis4Gordon Li5Adela Wu6Department of Neurosurgery, Stanford Health Care, Stanford, CA 94304, USADepartment of Extended Care and Palliative Medicine Service, VA Palo Alto Health Care System, Palo Alto, CA 94304, USADepartment of Neurosurgery, Stanford Health Care, Stanford, CA 94304, USADepartment of Neurology and Neurological Sciences, Stanford Health Care, Stanford, CA 94304, USADepartment of Neurosurgery, Stanford Health Care, Stanford, CA 94304, USADepartment of Neurosurgery, Stanford Health Care, Stanford, CA 94304, USADepartment of Neurosurgery, Stanford Health Care, Stanford, CA 94304, USAPatients with primary or secondary central nervous system (CNS) malignancies benefit from utilization of palliative care (PC) in addition to other supportive services, such as home health and social work. Guidelines propose early initiation of PC for patients with advanced cancers. We analyzed a cohort of privately insured patients with malignant brain or spinal tumors derived from the Optum Clinformatics Datamart Database to investigate health disparities in access to and utilization of supportive services. We introduce a novel construct, “provider patient racial diversity index” (provider pRDI), which is a measure of the proportion of non-white minority patients a provider encounters to approximate a provider’s patient demographics and suggest a provider’s cultural sensitivity and exposure to diversity. Our analysis demonstrates low rates of PC, home health, and social work services among racial minority patients. Notably, Hispanic patients had low likelihood of engaging with all three categories of supportive services. However, patients who saw providers categorized into high provider pRDI (categories II and III) were increasingly more likely to interface with supportive care services and at an earlier point in their disease courses. This study suggests that prospective studies that examine potential interventions at the provider level, including diversity training, are needed.https://www.mdpi.com/2072-6694/14/10/2567health inequitiesbrain cancerspinal tumoradvanced cancerracial diversitypalliative care |
| spellingShingle | Michael Chuwei Jin Gary Hsin John Ratliff Reena Thomas Corinna Clio Zygourakis Gordon Li Adela Wu Modifiers of and Disparities in Palliative and Supportive Care Timing and Utilization among Neurosurgical Patients with Malignant Central Nervous System Tumors Cancers health inequities brain cancer spinal tumor advanced cancer racial diversity palliative care |
| title | Modifiers of and Disparities in Palliative and Supportive Care Timing and Utilization among Neurosurgical Patients with Malignant Central Nervous System Tumors |
| title_full | Modifiers of and Disparities in Palliative and Supportive Care Timing and Utilization among Neurosurgical Patients with Malignant Central Nervous System Tumors |
| title_fullStr | Modifiers of and Disparities in Palliative and Supportive Care Timing and Utilization among Neurosurgical Patients with Malignant Central Nervous System Tumors |
| title_full_unstemmed | Modifiers of and Disparities in Palliative and Supportive Care Timing and Utilization among Neurosurgical Patients with Malignant Central Nervous System Tumors |
| title_short | Modifiers of and Disparities in Palliative and Supportive Care Timing and Utilization among Neurosurgical Patients with Malignant Central Nervous System Tumors |
| title_sort | modifiers of and disparities in palliative and supportive care timing and utilization among neurosurgical patients with malignant central nervous system tumors |
| topic | health inequities brain cancer spinal tumor advanced cancer racial diversity palliative care |
| url | https://www.mdpi.com/2072-6694/14/10/2567 |
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