Abstract 1301: Comparing VA and safety-net hospital patient-reported care metrics and provider recommendations to address social determinants of health and demographics
Authors: Hippalgaonkar Neha , Weinfeld Michael , Weldon Christine , Trosman Julia , Chan Cindy , Khan Sarah , Paduri Swetha , Reddy Vijay , Sakhuja Auradha , Khosla Paramjeet , Pasquinelli Mary , Feldman Lawrence 
Published: March 2024

Background: The Jesse Brown Department of Veterans Affairs Medical Center (JBVA) and Sinai Chicago, a safety-net hospital nearby, serve veterans and patients with significant social needs on Chicago's South and West sides. Both institutions are adopting the 4R Oncology Model (Right Info/Care/Patient/Time) for patient-facing care planning and self-management, proven to enhance supportive and health maintenance care delivery (Trosman JCOOP 2021). This abstract depicts a baseline survey of JBVA veterans’ and Sinai Chicago patients' experiences in planning and delivering guideline-directed supportive and health maintenance care for new cancer diagnoses, informing 4R implementations.

Methods: Patients at JBVA and Sinai Chicago were surveyed from February to September 2023 with participants receiving a $25 gift card. An analysis was conducted using Fisher’s two-tailed exact test.

Results: The two institutions yielded a 67% survey response rate. Key patient demographics and oncologic and supportive care metrics are outlined in the table below. At JBVA, fewer than 50% of veterans knew their cancer stage at diagnosis, and 63% were aware of their care goals. Furthermore, only 17% of veterans received recommendations for support services offered by JBVA. “Emotional distress or worry” support recommendations were received by &lt; 50% of patients at both institutions.

Conclusions: The baseline survey uncovered gaps in care planning, supportive services, and health maintenance care in both institutions, catering to patients with challenging social determinants of health. The implementation of the 4R Oncology Model is designed to address these gaps, providing a personalized care sequence that establishes a clear roadmap through the patient's care trajectory, ultimately enhancing patient-centered care. Further results will be shared when available.

Metric Combined% of pts(n=60) JBVA% of pts (n=30) SINAI% of pts(n=30) PVALUE Patient knew stage of their cancer 67 43 86 0.0005 Patient knew goal of their care 77 63 86 0.0442 Cancer care provider recommended to: Get Nutrition consult about how to eat during cancer treatment 35 27 42 0.2997 Talk to your primary care provider about staying as healthy as possible during care treatment 62 57 67 0.4523 Get support for transportation, food, housing, insurance, or other practical needs 44 17 67 0.0001 Get help to stop smoking or vaping* 29 28 31 1.0 Get help for emotional distress or worry* 37 24 46 0.1078 Demographics Age 59 66 53 0.0001 Male 69 93 39 0.0004 Black 59 83 39 0.0001 Hispanic 32 0 58 0.1103 High School education or less 68 57 78 0.1854 Household income less than $30,000 ** 70 59 81 0.1305 Live Alone 37 47 29 0.0001 *of those who reported needing help, **of those who shared income level

Citation Format: Neha Hippalgaonkar, Michael Weinfeld, Christine Weldon, Julia Trosman, Cindy Chan, Sarah Khan, Swetha Paduri, Vijay Reddy, Auradha Sakhuja, Paramjeet Khosla, Mary Pasquinelli, Lawrence Feldman. Comparing VA and safety-net hospital patient-reported care metrics and provider recommendations to address social determinants of health and demographics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1301.