Breast Cancer Treatment Delays at an Urban Safety Net Hospital Among Women Experiencing Homelessness

被引:16
作者
Festa, Kate [1 ]
Hirsch, Ariel E. [2 ]
Cassidy, Michael R. [3 ]
Oshry, Lauren [4 ]
Quinn, Kathryn [4 ]
Sullivan, Margaret M. [5 ]
Ko, Naomi Y. [4 ]
机构
[1] Boston Med Ctr, Boston, MA USA
[2] Boston Med Ctr, Dept Radiat Oncol, Boston, MA USA
[3] Boston Univ, Sch Med, Sect Surg Oncol, Dept Surg, Boston, MA 02118 USA
[4] Boston Univ, Sect Hematol & Oncol, Boston Med Ctr, Boston, MA 02215 USA
[5] Harvard TH Chan Sch Publ Hlth, Boston, MA USA
关键词
Homeless; Breast cancer; Treatment delay; Safety net hospital; HEALTH-CARE; MORTALITY;
D O I
10.1007/s10900-019-00759-x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Disparities in outcomes for vulnerable women is an ongoing problem. Homelessness and breast cancer treatment outcomes is understudied. This is a descriptive study exploring types of homelessness and treatment delays at an urban safety net hospital providing care to a vulnerable patient population.This study is a retrospective chart review of homeless female patients diagnosed with breast cancer between January 1, 2000 and December 31, 2014. Data for this study were acquired from the hospital cancer registry and electronic medical record. All demographic characteristics, time to treatment and factors related to delays to treatment were analyzed descriptively, reporting frequencies and proportions. The total number of individuals analyzed was 24. All except two subjects were delayed to treatment (>= 30 days from diagnosis to treatment). Most women in this cohort were categorized as chronically homeless (46%) with the rest categorized as transitionally (29%) or episodically (12%) homeless. The majority of subjects (70%) were Black, non-Hispanic. All except one subject were publicly insured (71% Medicaid; 12% Medicare) or uninsured (8%). Regardless of type of homelessness, most subjects were either 30-60 or 60-90 days delayed. Those who were chronically homeless experienced significantly more delays to first treatment (56% of those who were delayed 30-60 days and 57% of those who were delayed 60-90 days; p value 0.006) than those who were episodically or transitionally homeless. Significant delays and barriers to breast cancer treatment exist among women experiencing homelessness. Further studies to improve breast cancer care for homeless women are warranted.
引用
收藏
页码:452 / 457
页数:6
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