Hispanic Ethnicity as a Predictor of Voice Therapy Adherence

Rosow, David E.; Díaz, José Luis Gahete; Pan, Debbie R.; Lloyd, Adam

doi:10.1016/j.jvoice.2019.09.011

Cited by 10 publications

(10 citation statements)

References 22 publications

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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%

“…Following laryngeal cancer, voice disorders, deglutitive disorders, and airway disorders represent the remainder of pathologies examined across the U.S. disparity literature in laryngology. Granularity was present in the voice literature, with outcomes of patients with specific benign vocal fold lesions (such as polyps, nodules, and sulcus vocalis) being distinguished and studied within larger voice pathology cohorts 56,60–62,64,80 . All but one study 72 on disparities in the care of deglutitive disorders examined swallowing dysfunction and PEG placement following stroke.…”

Section: Discussionmentioning

confidence: 99%

“…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. 57,58 Males less likely to report receiving treatment for voice disorder (OR 0.36, 95% CI 0.16-0.79).…”

Section: Educationmentioning

confidence: 99%

“…Granularity was present in the voice literature, with outcomes of patients with specific benign vocal fold lesions (such as polyps, nodules, and sulcus vocalis) being distinguished and studied within larger voice pathology cohorts. 56,[60][61][62]64,80 All but one study 72 on disparities in the care of deglutitive disorders examined swallowing dysfunction and PEG placement following stroke. Though deliberately sought in our search strategy, only one paper examined airway pathologies.…”

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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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Educationmentioning

confidence: 99%

Section: Educationmentioning

confidence: 99%

Section: Voice Disordersmentioning

confidence: 99%

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Healthcare Disparities in Laryngology: A Scoping Review

et al. 2020

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Association of Sociodemographic Factors on the Presentation and Management of Unilateral Vocal Fold Immobility

et al. 2023

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ObjectiveTo determine the association of social determinants of health (SDOH) on the presentation and management of unilateral vocal fold immobility (UVFI).MethodsRetrospective chart review of 207 adult UVFI patients evaluated at a tertiary‐care hospital between 2018 and 2019 was performed. Sociodemographic factors including gender, median household income, preferred language, and insurance type were recorded. Confounding clinical factors including etiology of UVFI, Voice Handicap Index‐10 (VHI‐10) score, laryngoscopic findings, and intervention history were extracted from medical records. Multivariable logistic regression was performed using sociodemographic and clinical factors.ResultsPatient demographics and socioeconomic status were not associated with time to presentation. Patients presenting with glottic insufficiency and UVFI due to malignancy or recurrent laryngeal nerve (RLN) sacrifice had a shorter time to presentation. Higher household income was associated with greater number of interventions (p = 0.02), but neither income nor insurance type affected intervention type or timing. Female patients were less likely to undergo injection medialization laryngoplasty (odds ratio [OR] 0.25, p = 0.005). Older patients were more likely to undergo injection (OR 1.04, p = 0.027). Patients with large glottic gaps (OR 21.2, p = 0.014) and higher VHI‐10 scores (OR 1.06, p = 0.047) were more likely to undergo surgery.ConclusionHigher household income was associated with greater number of interventions and longer duration of care at a private tertiary‐care hospital. RLN sacrifice, known malignancy, and glottic insufficiency significantly reduced the time to presentation. Type of intervention received was a complex interplay of both demographic and clinical factors. Large prospective studies should examine the role of SDOH in the presentation and management of UVFI.Level of evidence4 Laryngoscope, 2023

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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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Hispanic Ethnicity as a Predictor of Voice Therapy Adherence

Cited by 10 publications

References 22 publications

Healthcare Disparities in Laryngology: A Scoping Review

Healthcare Disparities in Laryngology: A Scoping Review

Association of Sociodemographic Factors on the Presentation and Management of Unilateral Vocal Fold Immobility

Demographic differences in the treatment of unilateral vocal fold paralysis

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