Socioeconomic and demographic factors predictive of same day access utilization in outpatient radiation oncology.

Abstract

Access to medical care extends to not only the timely and appropriate receipt of services but also addresses inclusivity and underlying determinants of health. Given that patients from disadvantaged backgrounds have been shown to be more likely to experience delays in care, a same day access scheduling initiative was proposed to address this equity issue. Therefore, this study aims to evaluate our experience, focusing on identifying socioeconomic and demographic patterns of same day access utilization. From March 2021 to January 2023, all patients referred for new consultation to a tertiary care-based radiation oncology department were offered same day appointments as part of a prospective pilot initiative. Descriptive statistics were used to identify factors predictive of utilization. On multivariate analysis, patient characteristics independently associated with higher odds of same day access utilization included low-income status ([OR]=3.70, 95% CI (1.47-6.14)) and Black or Latino race ([OR]=4.05, 95% CI: 1.72-9.11). While we were unable to acquire data on actual clinical outcomes for patients opting for same day appointments, the enthusiasm for this program was obvious. Patients from disadvantaged backgrounds and vulnerable segments of the population were more likely to elect for same day appointments. Implications on health equity are discussed. Patient-centered approaches to overcome barriers of access can potentially help ensure that care is equitable. Our findings, representing the first published data analyzing a longitudinal experience with same day appointments in oncology, strongly suggest that certain disadvantaged populations may benefit more from access initiatives.