Neighborhood material deprivation and days at home after glioblastoma diagnosis.

PURPOSE: To examine the association between neighborhood material deprivation and days at home (DAH) after glioblastoma diagnosis.

METHODS

This population-based retrospective cohort study used linked administrative data from Ontario, Canada, for adults diagnosed with glioblastoma during 2003-2023. Material deprivation was assigned using Ontario Marginalization Index quintiles (Q1, least deprived; Q5, most deprived). The primary outcome was DAH within 365 days, defined as days alive outside acute hospitals, inpatient rehabilitation, and continuing or complex care. The primary analysis included diagnoses through 2022. Median quantile regression adjusted for age, sex, comorbidity, frailty, rurality, and diagnosis year. Secondary outcomes included other DAH horizons and overall survival.

RESULTS

Among 9172 adults, 4491 (49.0%) were younger than 65 years and 5435 (59.3%) were male. Median DAH-365 was 249 days (interquartile range, 67-350) in Q1 and 138 (27-332) in Q5. In 8234 complete cases, adjusted median differences versus Q1 were - 8.8 days for Q2 (95% confidence interval [CI], - 19.6 to 2.0), - 14.8 for Q3 (- 27.0 to - 2.6), - 18.3 for Q4 (- 29.4 to - 7.2), and - 36.2 for Q5 (- 51.5 to - 20.9). Median survival was 324 days (95% CI, 306-343) in Q1 and 225 (211-244) in Q5.

CONCLUSION

Greater neighborhood material deprivation was associated with substantially fewer DAH after glioblastoma diagnosis. The adjusted gap exceeding 5 weeks supports investigation of treatment access and supportive care pathways to inform efforts to improve equity.