Identifying Barriers to Timely Follow-up After Elevated PSA Screening: A Retrospective Analysis of a Large Healthcare System - Beyond the Abstract

Our research, titled "Identifying Barriers to Timely Follow-up After Elevated PSA Screening: A Retrospective Analysis of a Large Healthcare System," analyzed follow-up patterns for over 28,000 patients to understand the timeliness of care post-elevated PSA screening across different healthcare settings. We discovered significant disparities, with patients at academic medical centers receiving more prompt follow-up care compared to those at community sites. This difference underscores a disparity in service delivery that could impact patient outcomes.

The variations in follow-up rates highlight a critical issue: the inequity of access to specialized care, particularly in less centralized healthcare settings. Patients in community settings are disadvantaged by slower referral times and potentially by less coordinated care processes. This disparity can be more than simply a logistical issue and potentially contribute to worsened health outcomes for patients diagnosed in the community.

Addressing these disparities requires systemic changes, especially in the current age of growing mega healthcare systems that consist of both tertiary facilities and community sites. Our study suggests the need for standardized follow-up protocols across all facilities and enhanced communication between primary care providers and specialists. Furthermore, patient navigation programs could be instrumental in assisting patients through complex healthcare pathways, ensuring they receive the necessary care promptly.

By implementing targeted interventions within healthcare systems, potentially telemedicine to bridge geographical gaps, or even AI-driven tools to streamline care coordination, we could improve the consistency and quality of follow-up care. These changes are crucial not only for improving health outcomes but also for ensuring equitable care delivery across diverse patient populations.

Written by: Zhiyu (Jason) Qian, MD, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA

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