Afke Ekels, Lonneke V. van de Poll-Franse, Djamila E. Issa, Margriet Oosterveld, René van der Griend, Mels Hoogendoorn, Adrianus Koster, Marten R. Nijziel, Lindy P. J. Arts, Eduardus F. M. Posthuma, Simone Oerlemans
{"title":"血液系统恶性肿瘤患者确诊后 11 年内的医疗保健使用情况及其与社会经济地位的关系","authors":"Afke Ekels, Lonneke V. van de Poll-Franse, Djamila E. Issa, Margriet Oosterveld, René van der Griend, Mels Hoogendoorn, Adrianus Koster, Marten R. Nijziel, Lindy P. J. Arts, Eduardus F. M. Posthuma, Simone Oerlemans","doi":"10.1007/s11764-024-01676-2","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To investigate health care utilization among patients with hematologic malignancies and its association with socioeconomic position (SEP) and compare health care utilization with a cancer-free population.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Patients with aggressive lymphoma, indolent lymphoma, or multiple myeloma (MM), diagnosed between 1999–2010 and 2015–2019, participated in longitudinal patient-reported outcome research, up to 11 years post-diagnosis. Questionnaires assessed health care utilization at the general practitioner (GP), medical specialist, and additional health care. SEP was based on education and income, categorized as low, medium, or high. Sociodemographic and clinical data were obtained from the Netherlands Cancer Registry. Mixed models and logistic regression analyses were performed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The study included 2319 patients (71% response rate), who completed on average five measurements. Patients with MM reported the highest health care utilization, both at the GP and medical specialist. Low SEP was associated with higher utilization at the GP (medium education <i>β</i> = − 0.72, <i>p</i> = 0.01; high education <i>β</i> = − 1.15, <i>p</i> < 0.001) and lower utilization of additional physical (OR = 1.7, <i>p</i> = 0.01) and psychosocial (OR = 1.5, <i>p</i> < 0.05) care, among all patients. For patients with MM, high SEP was also associated with higher utilization of health care at the medical specialist (high education <i>β</i> = 2.56, <i>p</i> < 0.05).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Hematologic malignancy–related and SEP-related disparities in health care utilization were observed. To ensure equal access to health consumption, attention is needed for patients with a low SEP to provide better guidance in their cancer (survivorship) care.</p><h3 data-test=\"abstract-sub-heading\">Implications for Cancer Survivors</h3><p>Improving health literacy and involving informal caregivers and nurse-led patient navigation may help reduce disparities in access to (additional) health care.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Health care utilization up to 11 years after diagnosis among patients with a hematologic malignancy and its association with socioeconomic position\",\"authors\":\"Afke Ekels, Lonneke V. van de Poll-Franse, Djamila E. Issa, Margriet Oosterveld, René van der Griend, Mels Hoogendoorn, Adrianus Koster, Marten R. Nijziel, Lindy P. J. Arts, Eduardus F. M. Posthuma, Simone Oerlemans\",\"doi\":\"10.1007/s11764-024-01676-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose</h3><p>To investigate health care utilization among patients with hematologic malignancies and its association with socioeconomic position (SEP) and compare health care utilization with a cancer-free population.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>Patients with aggressive lymphoma, indolent lymphoma, or multiple myeloma (MM), diagnosed between 1999–2010 and 2015–2019, participated in longitudinal patient-reported outcome research, up to 11 years post-diagnosis. Questionnaires assessed health care utilization at the general practitioner (GP), medical specialist, and additional health care. SEP was based on education and income, categorized as low, medium, or high. Sociodemographic and clinical data were obtained from the Netherlands Cancer Registry. Mixed models and logistic regression analyses were performed.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>The study included 2319 patients (71% response rate), who completed on average five measurements. Patients with MM reported the highest health care utilization, both at the GP and medical specialist. Low SEP was associated with higher utilization at the GP (medium education <i>β</i> = − 0.72, <i>p</i> = 0.01; high education <i>β</i> = − 1.15, <i>p</i> < 0.001) and lower utilization of additional physical (OR = 1.7, <i>p</i> = 0.01) and psychosocial (OR = 1.5, <i>p</i> < 0.05) care, among all patients. For patients with MM, high SEP was also associated with higher utilization of health care at the medical specialist (high education <i>β</i> = 2.56, <i>p</i> < 0.05).</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>Hematologic malignancy–related and SEP-related disparities in health care utilization were observed. 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Health care utilization up to 11 years after diagnosis among patients with a hematologic malignancy and its association with socioeconomic position
Purpose
To investigate health care utilization among patients with hematologic malignancies and its association with socioeconomic position (SEP) and compare health care utilization with a cancer-free population.
Methods
Patients with aggressive lymphoma, indolent lymphoma, or multiple myeloma (MM), diagnosed between 1999–2010 and 2015–2019, participated in longitudinal patient-reported outcome research, up to 11 years post-diagnosis. Questionnaires assessed health care utilization at the general practitioner (GP), medical specialist, and additional health care. SEP was based on education and income, categorized as low, medium, or high. Sociodemographic and clinical data were obtained from the Netherlands Cancer Registry. Mixed models and logistic regression analyses were performed.
Results
The study included 2319 patients (71% response rate), who completed on average five measurements. Patients with MM reported the highest health care utilization, both at the GP and medical specialist. Low SEP was associated with higher utilization at the GP (medium education β = − 0.72, p = 0.01; high education β = − 1.15, p < 0.001) and lower utilization of additional physical (OR = 1.7, p = 0.01) and psychosocial (OR = 1.5, p < 0.05) care, among all patients. For patients with MM, high SEP was also associated with higher utilization of health care at the medical specialist (high education β = 2.56, p < 0.05).
Conclusion
Hematologic malignancy–related and SEP-related disparities in health care utilization were observed. To ensure equal access to health consumption, attention is needed for patients with a low SEP to provide better guidance in their cancer (survivorship) care.
Implications for Cancer Survivors
Improving health literacy and involving informal caregivers and nurse-led patient navigation may help reduce disparities in access to (additional) health care.
期刊介绍:
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.