Multidisciplinary service utilization pattern by advanced head and neck cancer patients: a single institution study

Jacqueline C Junn, Irene A Kim, Marianna L Zahurak, Marietta Tan, Katherine Y Fan, Spencer T Lake, David Zaboli, Barbara P Messing, Karen Ulmer, Karen B Harrer, Dorothy Gold, Keri L Ryniak, Eva S Zinreich, Mei Tang, Marshall A Levine, Ray G Blanco, John R Saunders, Joseph A Califano, Patrick K Ha, Jacqueline C Junn, Irene A Kim, Marianna L Zahurak, Marietta Tan, Katherine Y Fan, Spencer T Lake, David Zaboli, Barbara P Messing, Karen Ulmer, Karen B Harrer, Dorothy Gold, Keri L Ryniak, Eva S Zinreich, Mei Tang, Marshall A Levine, Ray G Blanco, John R Saunders, Joseph A Califano, Patrick K Ha

Abstract

Purpose. To analyze the patterns and associations of adjunctive service visits by head and neck cancer patients receiving primary, concurrent chemoradiation therapy. Methods. Retrospective chart review of patients receiving adjunctive support during a uniform chemoradiation regimen for stages III-IV head and neck squamous cell carcinoma. Univariate and multivariate models for each outcome were obtained from simple and multivariate linear regression analyses. Results. Fifty-two consecutive patients were assessed. Female gender, single marital status, and nonprivate insurance were factors associated with an increased number of social work visits. In a multivariate analysis, female gender and marital status were related to increased social work services. Female gender and stage IV disease were significant for increased nursing visits. In a multivariate analysis for nursing visits, living greater than 20 miles between home and hospital was a negative predictive factor. Conclusion. Treatment of advanced stage head and neck cancer with concurrent chemoradiation warrants a multidisciplinary approach. Female gender, single marital status, and stage IV disease were correlated with increased utilization of social work and nursing services. Distance over 20 miles from the center was a negative factor. This information may help guide the treatment team to allocate resources for the comprehensive care of patients.

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