Upstream Gynecology: Identifying Social Determinants of Health in a Gynecologic Oncology Population [40H

Abstract

INTRODUCTION: Social determinants of health (SDoH) are factors that affect a patient’s health quality and outcomes. Evidence suggests that clinical care contributes only 20% to patient outcomes, while the remainder is under the influence of upstream factors. The upstream approach to healthcare aims to address SDoH before they contribute to less ideal outcomes downstream. Several social determinants of health may contribute to outcomes for cancer patients. This Upstream Gynecologic Oncology Initiative seeks to identify which SDoH affect patients with gynecologic malignancies. METHODS: This needs assessment is the first step in a quality improvement project assessing the SDoH affecting women with gynecologic cancers. Female patients receiving care for gynecologic malignancies were invited to complete an anonymous needs assessment survey. Validated survey questions regarding housing, food, transportation, finances, health literacy and social support were used to identify needs. Data collected is being used to further develop a routine screening tool and to organize resources specific to the identified needs. RESULTS: Results demonstrate the relative prevalence of existing SDoH needs upstream of clinical care within this unique gynecologic oncology patient population. Results from the study population are also compared to prevalence among the general population of this institution's state. CONCLUSION: Upstream SDoH are identified to be present and likely contributing to health quality and outcomes within this gynecologic oncology patient population. Appreciation and assessment of their potential to impact care and management can be used to design a routine screening tool for the study population and organize resources to address or mitigate the identified needs.