Fractured and delayed: A qualitative analysis of disruptions in care for gynecologic malignancies during incarceration.
Carceral health care
Gynecologic cancers
Health disparities
Incarceration
Qualitative research
Journal
Gynecologic oncology
ISSN: 1095-6859
Titre abrégé: Gynecol Oncol
Pays: United States
ID NLM: 0365304
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
04
04
2023
revised:
13
06
2023
accepted:
21
06
2023
pmc-release:
01
09
2024
medline:
4
9
2023
pubmed:
2
7
2023
entrez:
2
7
2023
Statut:
ppublish
Résumé
Women are experiencing growing rates of incarceration at twice the pace of that for men. Additionally, one-third will be older than 55 years of age by the end of the decade. Women who are incarcerated experience a higher prevalence of gynecologic malignancies and present with higher stage disease, which may be contributing to the greater mortality from cancer than the age-adjusted US population. Limited access to guideline-recommended screening and prevention and resource limitations across correctional facilities may result in gynecologic cancer disparities. Reasons for delayed gynecologic cancer care in prisons remain underexplored. Therefore, we sought to identify contributors to delayed gynecologic cancer care among women experiencing incarceration. Women at a single tertiary center in the Southeastern U.S. who were incarcerated and were diagnosed with a gynecologic cancer during 2014-2021 were identified in the electronic medical record. Note text was extracted and contributors to delay were identified and categorized using the RADaR method. Descriptive statistics were used to assess quantitative data. 14 patients were identified with a total of 14,879 text excerpts. Data reduction was performed to identify excerpts that were relevant to the central research question resulting in 175 relevant note excerpts. Delays prior to the tertiary care visit included patient and institutional contributors. Delays during transition from the tertiary center to prison included discharge planning and loss to follow-up during/after incarceration. Transportation, authorization, and restraints were concrete contributors. Abstract contributors included communication, and the patient's emotional experience. We identify myriad contributors to delayed or fractured gynecologic cancer care in women experiencing incarceration. The impact of these issues warrants further study and intervention to improve care.
Identifiants
pubmed: 37393632
pii: S0090-8258(23)00370-0
doi: 10.1016/j.ygyno.2023.06.017
pmc: PMC10528285
mid: NIHMS1914143
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-9Subventions
Organisme : NICHD NIH HHS
ID : K12 HD103085
Pays : United States
Informations de copyright
Copyright © 2023 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
Références
J Health Care Poor Underserved. 2012 May;23(2):557-69
pubmed: 22643607
Biores Open Access. 2018 Sep 20;7(1):139-144
pubmed: 30250761
N C Med J. 2019 Nov-Dec;80(6):332-337
pubmed: 31685564
J Am Geriatr Soc. 2012 Jun;60(6):1150-6
pubmed: 22642489
Annu Rev Public Health. 2016;37:313-33
pubmed: 26789388
PLoS One. 2017 Feb 22;12(2):e0171131
pubmed: 28225780
J Womens Health (Larchmt). 2021 Jul;30(7):956-963
pubmed: 33232627
J Womens Health (Larchmt). 2010 Jan;19(1):17-22
pubmed: 20088654
Am J Public Health. 2015 Nov;105 Suppl 5:S706-12
pubmed: 26447909
Gynecol Oncol. 2014 Nov;135(2):261-5
pubmed: 25230215
Womens Health Issues. 2017 Nov - Dec;27(6):625-631
pubmed: 28774479
JAMA Netw Open. 2018 Dec 7;1(8):e185637
pubmed: 30646279
JAMA Surg. 2021 Oct 1;156(10):964-973
pubmed: 34406357
Am J Public Health. 2008 Dec;98(12):2278-84
pubmed: 18923131
Lancet. 2017 Apr 8;389(10077):1464-1474
pubmed: 28402828
Annu Rev Public Health. 2012 Apr;33:325-39
pubmed: 22224880
J Gen Intern Med. 2020 Mar;35(3):967-968
pubmed: 31321602
J Aging Health. 2022 Jan;34(1):60-70
pubmed: 34120499
J Low Genit Tract Dis. 2021 Apr 1;25(2):81-85
pubmed: 33631779
Soc Sci Med. 2018 Oct;215:45-52
pubmed: 30205278
J Correct Health Care. 2019 Jul;25(3):219-230
pubmed: 31242811
Am J Prev Med. 2023 Feb;64(2):244-249
pubmed: 36653100
Gynecol Oncol. 2003 Feb;88(2):89-95
pubmed: 12586585
Cancer. 2005 Nov 15;104(10):2197-204
pubmed: 16206295
Ann Intern Med. 2015 Mar 3;162(5):345-52
pubmed: 25732276
Cancer Med. 2021 Oct;10(20):7277-7288
pubmed: 34477309
Int J Radiat Oncol Biol Phys. 2023 May 1;116(1):194-198
pubmed: 36758643