Radiation Oncology access program reduces racial disparities

Researchers are highlighting the success of a same-day radiation oncology access initiative that reduced racial disparities, their findings being published September 14 in the Journal of Cancer Policy

The team, led by Allen Chen, MD, from the University of California, Irvine found that their initiative led to increased proportions of patients from different ethnic and racial backgrounds seen within five days from referral, as well as decreases in no-show rates. 

"Patient-centered approaches such as same-day access can potentially help ensure that care is equitable and culturally competent," Chen and colleagues wrote. 

Previous radiation oncology studies show that underrepresented populations have higher rates of cancer morbidity and mortality. This includes Black individuals being twice as likely to die from their cancer than white individuals.

Chen and co-authors wanted to present results from their single-institution experience with a same-day access scheduling initiative for an outpatient radiation oncology unit. They sought to focus on its potential influence on reducing racial disparities.

The researchers ran the pilot initiative between 2021 and 2022. Here, all new patients who were referred to a tertiary care-based radiation oncology department were offered the ability to be seen as a same-day consultation. The team categorized the time span of its study into two successive periods over 36 months. These included an 18-month preinitiative period and a subsequent period.

The team reported that of the 2,107 patients scheduled, 316 (15%) took up the offer for same-day consultation. The authors found that Black (24%), Latino (18%), and Asian patients (16%) were significantly more likely to use the same-day access initiative than white patients (11%).

The researchers also found that same-day access significantly increased the proportion of patients seen within five days from referral for Black, Latino, and Asian patients. This included increases from 8% to 34% for Black patients, from 12% to 57% for Latino patients, and from 18% to 67% for Asian patients. In comparison, white patients experienced a proportional increase from 39% to 55% (p < 0.001).

Finally, the team reported that the no-show rate dropped from 20% to 7% for Black patients, and from 14% to 5% for Latino patients (p < 0.001).

The study authors suggested that providing access to same-day consultation such as in this study may lead to improved trust in medical providers by underrepresented populations.

However, they wrote that for programs like this to be successful, thoughtful engagement from all stakeholders and appropriate resource allocation are needed. For the latter, this will address issues related to transportation, employment, and implicit bias, among others.

“Ultimately, recognizing the unique challenges facing vulnerable populations — logistically, emotionally, financially, socially — will be critical to empower these segments and to eliminate healthcare disparities in the future,” the authors wrote.

The full results can be found here.  

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