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Social inequalities in supportive care needs and quality of patient-centered care of cancer patients in Mexico

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Abstract

Purpose

To evaluate educational and health insurance–related inequalities in supportive care (SC) needs and quality of patient-centered care (PCC) for cancer patients in Mexico.

Methods

We conducted a cross-sectional survey in one Mexican Institute of Social Security (IMSS) and one Ministry of Health (MoH) oncology hospital in Mexico City. Formal labor market workers and their families have access to social health insurance that IMSS provides, while unemployed and informal workers receive care at the MoH. The study population comprised breast, colorectal, prostate, and hematologic cancer patients, aged ≥ 18 years, who attended outpatient consultations. Patients responded a short-form SC-needs questionnaire and a quality of PCC questionnaire. We used multiple logistic regression models to determine the independent association between educational attainment and high SC-needs and quality of PCC after controlling for sociodemographic and clinical covariates.

Results

We included 1058 IMSS and 606 MoH cancer patients. MoH patients perceived higher SC-needs and lower quality of PCC than IMSS patients. MoH patients with low education had a greater probability of high psychological and health system SC needs and lower likelihood of being informed for treatment decision-making and care for their biopsychosocial needs. IMSS patients with low educational levels had lower probability of receiving timely care and clarity of information than those with high education. Receiving high-quality PCC was associated with decreased SC needs.

Conclusion

Uninsured cancer patients with low educational attainment have higher SC-needs and receive lower quality of PCC than their counterparts. Health services should face these challenges to reduce inequalities in Mexico.

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Data availability

The data that support the findings of this study are not publicly available due to ethical restrictions of the IMSS National Research and Ethics Committee. The authors agree to provide the journal with the data to review it if requested.

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Code availability

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Funding

This work was supported by the Fund for the Promotion of Health Research, IMSS (grant number FIS/IMSS/PROT/G17-211759).

Author information

Authors and Affiliations

  1. Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico

    Svetlana V. Doubova & Ingrid Patricia Martinez-Vega

  2. Institute of Social Research, National Autonomous University of Mexico, Mexico City, Mexico

    Claudia Infante-Castañeda

  3. Servicio de Oncología, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de Mexico, México

    Carlos E. Aranda-Flores

  4. Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA

    Felicia M Knaul

  5. Department of Public Health Sciences, Leonard M. Miller School of Medicine, Miami, FL, USA

    Felicia M Knaul

  6. Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA

    Felicia M Knaul

  7. Tómatelo a Pecho & Mexican Health Foundation (FUNSALUD), Mexico City, Mexico

    Felicia M Knaul

  8. Division of Social Protection and Health, Jamaica Country Office, Interamerican Development Bank, Kingston, Jamaica

    Ricardo Pérez-Cuevas

Authors
  1. Svetlana V. Doubova
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  2. Ingrid Patricia Martinez-Vega
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  3. Claudia Infante-Castañeda
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  4. Carlos E. Aranda-Flores
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  5. Felicia M Knaul
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  6. Ricardo Pérez-Cuevas
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Corresponding author

Correspondence to Svetlana V. Doubova.

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The authors declare that they have no competing interests.

Ethics approval

The study was approved by the IMSS National Research and Ethics Committee (registry number R-2017-785-042).

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All patients signed consent form prior to their participation.

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Doubova, S.V., Martinez-Vega, I.P., Infante-Castañeda, C. et al. Social inequalities in supportive care needs and quality of patient-centered care of cancer patients in Mexico. Support Care Cancer 29, 1355–1367 (2021). https://doi.org/10.1007/s00520-020-05615-6

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  • DOI: https://doi.org/10.1007/s00520-020-05615-6

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