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Health care utilization up to 11 years after diagnosis among patients with a hematologic malignancy and its association with socioeconomic position.

Afke Ekels ,
Lonneke V van de Poll-Franse ,
Djamila E Issa ,
Margriet Oosterveld ,
René van der Griend ,
Mels Hoogendoorn ,
Adrianus Koster ,
Marten R Nijziel ,
Lindy P J Arts ,
Eduardus F M Posthuma ,
Simone Oerlemans

Abstract

METHODS

Patients with aggressive lymphoma, indolent lymphoma, or multiple myeloma (MM), diagnosed between 1999-2010 and 2015-2019, participated in longitudinal patient-reported outcome research, up to 11 years post-diagnosis. Questionnaires assessed health care utilization at the general practitioner (GP), medical specialist, and additional health care. SEP was based on education and income, categorized as low, medium, or high. Sociodemographic and clinical data were obtained from the Netherlands Cancer Registry. Mixed models and logistic regression analyses were performed.

CONCLUSION

Hematologic malignancy-related and SEP-related disparities in health care utilization were observed. To ensure equal access to health consumption, attention is needed for patients with a low SEP to provide better guidance in their cancer (survivorship) care.

RESULTS

The study included 2319 patients (71% response rate), who completed on average five measurements. Patients with MM reported the highest health care utilization, both at the GP and medical specialist. Low SEP was associated with higher utilization at the GP (medium education β =  - 0.72, p = 0.01; high education β =  - 1.15, p < 0.001) and lower utilization of additional physical (OR = 1.7, p = 0.01) and psychosocial (OR = 1.5, p < 0.05) care, among all patients. For patients with MM, high SEP was also associated with higher utilization of health care at the medical specialist (high education β = 2.56, p < 0.05).

PURPOSE

To investigate health care utilization among patients with hematologic malignancies and its association with socioeconomic position (SEP) and compare health care utilization with a cancer-free population.

IMPLICATIONS FOR CANCER SURVIVORS

Improving health literacy and involving informal caregivers and nurse-led patient navigation may help reduce disparities in access to (additional) health care.

More about this publication

Journal of cancer survivorship : research and practice

Volume 20
Issue nr. 2
Pages 620-632
Publication date 01-04-2026

Full text links

Publisher website (DOI) 10.1007/s11764-024-01676-2
Europe PubMed Central 39287915
Pubmed 39287915

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