TY - JOUR
T1 - Social inequalities in supportive care needs and quality of patient-centered care of cancer patients in Mexico
AU - Doubova, Svetlana V.
AU - Martinez-Vega, Ingrid Patricia
AU - Infante-Castañeda, Claudia
AU - Aranda-Flores, Carlos E.
AU - Knaul, Felicia M.
AU - Pérez-Cuevas, Ricardo
N1 - Funding Information:
This work was supported by the Fund for the Promotion of Health Research, IMSS (grant number FIS/IMSS/PROT/G17-211759). Code availability
Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/3
Y1 - 2021/3
N2 - Purpose: To evaluate educational and health insurance–related inequalities in supportive care (SC) needs and quality of patient-centered care (PCC) for cancer patients in Mexico. Methods: We conducted a cross-sectional survey in one Mexican Institute of Social Security (IMSS) and one Ministry of Health (MoH) oncology hospital in Mexico City. Formal labor market workers and their families have access to social health insurance that IMSS provides, while unemployed and informal workers receive care at the MoH. The study population comprised breast, colorectal, prostate, and hematologic cancer patients, aged ≥ 18 years, who attended outpatient consultations. Patients responded a short-form SC-needs questionnaire and a quality of PCC questionnaire. We used multiple logistic regression models to determine the independent association between educational attainment and high SC-needs and quality of PCC after controlling for sociodemographic and clinical covariates. Results: We included 1058 IMSS and 606 MoH cancer patients. MoH patients perceived higher SC-needs and lower quality of PCC than IMSS patients. MoH patients with low education had a greater probability of high psychological and health system SC needs and lower likelihood of being informed for treatment decision-making and care for their biopsychosocial needs. IMSS patients with low educational levels had lower probability of receiving timely care and clarity of information than those with high education. Receiving high-quality PCC was associated with decreased SC needs. Conclusion: Uninsured cancer patients with low educational attainment have higher SC-needs and receive lower quality of PCC than their counterparts. Health services should face these challenges to reduce inequalities in Mexico.
AB - Purpose: To evaluate educational and health insurance–related inequalities in supportive care (SC) needs and quality of patient-centered care (PCC) for cancer patients in Mexico. Methods: We conducted a cross-sectional survey in one Mexican Institute of Social Security (IMSS) and one Ministry of Health (MoH) oncology hospital in Mexico City. Formal labor market workers and their families have access to social health insurance that IMSS provides, while unemployed and informal workers receive care at the MoH. The study population comprised breast, colorectal, prostate, and hematologic cancer patients, aged ≥ 18 years, who attended outpatient consultations. Patients responded a short-form SC-needs questionnaire and a quality of PCC questionnaire. We used multiple logistic regression models to determine the independent association between educational attainment and high SC-needs and quality of PCC after controlling for sociodemographic and clinical covariates. Results: We included 1058 IMSS and 606 MoH cancer patients. MoH patients perceived higher SC-needs and lower quality of PCC than IMSS patients. MoH patients with low education had a greater probability of high psychological and health system SC needs and lower likelihood of being informed for treatment decision-making and care for their biopsychosocial needs. IMSS patients with low educational levels had lower probability of receiving timely care and clarity of information than those with high education. Receiving high-quality PCC was associated with decreased SC needs. Conclusion: Uninsured cancer patients with low educational attainment have higher SC-needs and receive lower quality of PCC than their counterparts. Health services should face these challenges to reduce inequalities in Mexico.
KW - Mexico
KW - Quality of patient-centered care
KW - Social inequalities
KW - Supportive care needs
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U2 - 10.1007/s00520-020-05615-6
DO - 10.1007/s00520-020-05615-6
M3 - Article
C2 - 32651679
AN - SCOPUS:85087717848
VL - 29
SP - 1355
EP - 1367
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
SN - 0941-4355
IS - 3
ER -