Compounding or confounding?—addressing context-specific disparities in access to outpatient specialty palliative care

Gynecologic cancer patients were less commonly referred to outpatient specialty palliative care if living in a distant, rural or disadvantaged county or if established with primary care. For our patient population, rurality and access to primary care were the primary SDOH driving referral to palliative care. This analysis demonstrates the importance of understanding effects of SDOH to tailor quality improvement interventions to prioritize the most pressing needs of a given patient population in a context-dependent manner.