Survey Details Barriers to Addressing SDOH of Oncology Patients

Feb. 19, 2024
ASCO task force highlights need for reliable data collection to help evaluate return-on-investment of intervention strategies

Respondents to an American Society of Clinical Oncology survey about working with underserved populations expressed the need for a return-on-investment model to support personnel, social needs screening, and collaborating with ASCO on advocacy and policy.

The ASCO Serving the Underserved Task Force was created in 2020 to address the lack of data on cancer care delivery among underserved populations, identify barriers and facilitators for care delivery to underserved populations, and propose solutions based on oncology professionals’ experiences.

The survey of 462 oncology professionals, administered from May to August 2022, was the first national U.S.-based survey assessing barriers and solutions of oncology professionals in their care delivery for underserved patients with cancer. 

The report based on the survey found that social workers coordinated a majority of health-related social services such as transportation, food, housing, mental health services, financial counseling, childcare, and employment.

The survey highlighted a lack of affordable, accessible mental health services among underserved patients with cancer, and the vital need for integrated, trained staff to deliver quality care in under-resourced settings.

Respondents relied on best guesses or estimates to report on the socioeconomic and demographic characteristics of their patient population. The report said this highlights the need for consistent, reliable data collection, which would in turn help to evaluate many aspects of care and return-on-investment of staffing models or intervention strategies.

“Although no perfect measures of social needs or equity exist, the current reliance on general estimation and proxy measures, combined with the lack of consistent, longitudinal data collection from patients, is problematic,” the report said. “Without valid and reliable data, evaluating return-on-investment of any staffing model or intervention strategy to support underserved populations becomes impossible. As population health and social needs measures become more consistently available within oncology settings, evaluation of appropriate staffing models to meet the needs of underserved populations becomes an easier lift and may enhance the ability of a practice to demonstrate return on investment (in both financial and patient outcome terms).”

Integrating validated screening and intervention tools into work flows and electronic health records is vital, the report said. 

The task force said that resource allocations should include consideration of integrating social services, public health, mental health, and community partnerships into clinical practice.

“These results emphasize the critical need for partnerships between clinicians serving the underserved and professional societies such as ASCO, who may advocate for policies to address inequitable care delivery such as payment models that support data collection of health-related social needs,” said Manali I. Patel, M.D., lead author of the study and co-chair of the task force, in a statement. “They may also advocate for reimbursement aligned with health equity measures, as well as resources to support personnel such as social workers, navigators, and community health workers.”

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