Patient-reported physical and mental health of socioeconomically disadvantaged cancer patients.

Abstract

e19041 Background: Patient-reported outcomes (PROs) are extensively described for cancer patients with access to care, but little information is available about PROs for socioeconomically disadvantaged cancer patients with barriers to care. Therefore, we aimed to compare patient-reported mental and physical health between newly diagnosed cancer patients at an urban safety-net cancer center and the general population. Methods: We used data collected during implementation of a quality improvement pilot initiative to integrate PROs into clinical care at the JPS Oncology and Infusion Center (Fort Worth, TX), which is a Comprehensive Community Cancer Program. The Patient-Reported Outcomes Measurement Information System (PROMIS) 10-item Global Health Survey was used to ascertain mental, physical, and social health for newly diagnosed cancer patients between August and December 2019. Our outcomes of interest were the mental and physical health subdomains. We computed T-scores, where a score of 50 represents the mean for the U.S. general population with a standard deviation (SD) of 10. We defined severely impaired health as subdomain scores ≥2 SDs below the mean. In addition, we estimated standardized morbidity ratios (SMR) and corresponding 95% confidence limits (CL) to compare the observed number of patients with severe impairment of mental or physical health with the expected number of patients with severe impairment. For example, an SMR = 1.0 implies that the observed number of severely impaired individuals in the study population is equal to the expected number in the general population. Results: Our study population comprised 59 patients, of whom 73% were aged < 65 years, 51% were female, and 54% were racial/ethnic minorities. Breast (21%) and lung (21%) cancers were the most common diagnoses. The frequency of severely impaired physical health for our population was 4.4 times higher than the general population (SMR = 4.4, 95% CL: 1.6, 9.6), whereas no patients in our study population reported severely impaired mental health (SMR = 0, 95% CL: 0, 2.2). Conclusions: Our results suggest that socioeconomically disadvantaged cancer patients have substantially impaired physical health but not mental health at diagnosis. These findings may be useful for raising awareness about the importance of systematically ascertaining PROs and using the results to allocate resources for delivering care to safety-net cancer patients.