The “New Normal” of Cancer Treatment Delays Is Nothing New

Baum, Laura Van Metre; Kline, Kathryn A. F.; Smith, Cardinale B.

doi:10.1001/jamanetworkopen.2020.30507

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…Differential access to cancer care services contributes to existing cancer disparities, with racially and ethnically minoritized patient populations and patients with LEP at risk for worse patient outcomes . Our current study, which focused on evaluating access to a new clinic appointment for cancer care, complements prior work that identified substantial linguistic barriers to cancer care access at the level of the hospital general information line, as well as a prior study identifying barriers to access in non-cancer settings .…”

Section: Discussionmentioning

confidence: 99%

“…Cancer disparities in the US are associated, in part, with differential access to cancer care services . However, the experiences of vulnerable patient populations, including patients with limited English proficiency (LEP), have been understudied.…”

Section: Introductionmentioning

confidence: 99%

“…Cancer disparities in the US are associated, in part, with differential access to cancer care services. 2 , 3 , 7 , 8 , 9 , 10 However, the experiences of vulnerable patient populations, including patients with limited English proficiency (LEP), have been understudied. Prior work has identified linguistic barriers to accessing cancer care services at the level of the hospital general information personnel.…”

Section: Introductionmentioning

confidence: 99%

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Access to New Clinic Appointments for Patients With Cancer

Chen,

Banerjee,

Gay

et al. 2024

JAMA Netw Open

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ImportanceRacial and ethnic disparities have been observed in the outpatient visit rates for specialist care, including cancer care; however, little is known about patients’ experience at the critical step of attempting to access new clinic appointments for cancer care.ObjectiveTo determine simulated English-speaking, Spanish-speaking, and Mandarin-speaking patient callers’ ability to access new clinic appointments for 3 cancer types (colon, lung, and thyroid cancer) that disproportionately impact Hispanic and Asian populations.Design, Setting, and ParticipantsThis cross-sectional audit study was conducted between November 2021 and March 2023 using 479 clinic telephone numbers that were provided by the hospital general information personnel at 143 hospitals located across 12 US states. Using standardized scripts, trained research personnel assigned to the roles of English-speaking, Spanish-speaking, and Mandarin-speaking patients called the telephone number for a clinic that treats colon, lung, or thyroid cancer to inquire about a new clinic appointment. Data analysis was conducted from June to September 2023.Main Outcomes and MeasuresThe primary outcome was whether the simulated patient caller was able to access cancer care (binary variable, yes or no), which was defined to include being provided with a clinic appointment date or scheduling information. Multivariable logistic regression analysis was performed to determine factors independently associated with simulated patient callers being able to access cancer care.ResultsOf 985 total calls (399 English calls; 302 Spanish calls; 284 Mandarin calls), simulated patient callers accessed cancer care in 409 calls (41.5%). Differences were observed based on language type, with simulated English-speaking patient callers significantly more likely to access cancer care compared with simulated Spanish-speaking and Mandarin-speaking patient callers (English, 245 calls [61.4%]; Spanish, 110 calls [36.4%]; Mandarin, 54 calls [19.0%]; P &lt; .001). A substantial number of calls ended due to linguistic barriers (291 of 586 Spanish or Mandarin calls [49.7%]) and workflow barriers (239 of 985 calls [24.3%]). Compared with English-speaking simulated patient callers, the odds of accessing cancer care were lower for Spanish-speaking simulated patient callers (adjusted odds ratio [aOR], 0.34; 95% CI, 0.25-0.46) and Mandarin-speaking simulated patient callers (aOR, 0.13; 95% CI, 0.09-0.19). Compared with contacting clinics affiliated with teaching hospitals, callers had lower odds of accessing cancer care when contacting clinics that were affiliated with nonteaching hospitals (aOR, 0.53; 95% CI, 0.40-0.70).Conclusions and RelevanceIn this cross-sectional audit study, simulated patient callers encountered substantial barriers when attempting to access clinic appointments for cancer care. These findings suggest that interventions focused on mitigating these barriers are necessary to increase access to cancer care for all patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Access to New Clinic Appointments for Patients With Cancer

Chen,

Banerjee,

Gay

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

“…Under such extraordinary conditions, hospital admissions of patients having complaints have decreased both due to the fear of contamination and quarantine practices [ 3 , 4 ]. On the other hand, it is known that the delay in diagnosis and treatment of cancer patients can sometimes be fatal [5] .…”

Section: Introductionmentioning

confidence: 99%