Lower odds of receiving key components of quality care seen for those with high overall social vulnerability index
By Elana Gotkine HealthDay Reporter
THURSDAY, April 17, 2025 (HealthDay News) — Among patients with metastatic pancreatic ductal adenocarcinoma (mPDAC), racial and ethnic minority patients and socially vulnerable populations are less likely to achieve quality indicators associated with survival, according to a study published in the April issue of the Journal of the National Comprehensive Cancer Network.
Diamantis I. Tsilimigras, M.D., Ph.D., from The Ohio State University Wexner Medical Center in Columbus, and colleagues examined trends and racial/ethnic disparities in quality of care among patients with mPDAC between 2005 and 2019 and the impact on outcomes using a quality metric. Achievement of a quality score was based on three criteria: cancer-specific survival (CSS) >12 months, systemic therapy receipt, and utilization of hospice/palliative care services.
A total of 14,147 patients were identified with mPDAC, and of these patients, 62.2 percent received systemic therapy, 83.3 percent utilized palliative care/hospice services, and 13.7 percent had CSS >12 months after diagnosis. The researchers found that over time, there was an increase in achievement of at least one quality criterion, from 84.5 percent in 2005 to 97.0 percent in 2019. A high overall social vulnerability index (SVI) was independently associated with lower odds of meeting at least one quality criterion (odds ratio, 0.70). The SVI subthemes of high socioeconomic status and high racial/ethnic minority status were the main drivers of this effect (odds ratios, 0.66 and 0.75). Improved overall survival was seen in association with achievement of a quality score ≥1 (excluding CSS criterion; one-year CSS, 14.5 versus 3.2 percent).
“These findings highlight the need for targeted interventions to improve quality metrics for all patients with PDAC to mitigate disparities in end-of-life care,” the authors write.
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