Does the distance a patient has to travel affect where they choose to get their care?

August 31, 2009

Do patients choose where to get their care based on how long it takes to them to get there? Researchers at Fox Chase Cancer Center have recently documented a growing trend in the centralization of cancer surgery—more patients seeking care at high volume centers, which are generally located in metropolitan areas. While trends like this should improve patient outcomes, a study published in the Journal of Clinical Oncology shows that there are still a good number of patients who will not travel a long distance to get their care.

"Based on results of previous studies, patient outcomes should be improved with centralization of cancer surgery, however, we are concerned that the long distances patients may need to travel will serve as a barrier to access to high volume centers," says Karyn Stitzenberg, M.D., M.P.H., who led the study while at Fox Chase and is currently adjunct assistant professor for the Department of Health Policy and Management at University of North Carolina. "Centralization at high volume centers comes with a cost, as some patients may need to travel long distances to reach high volume centers. These increased travel distances may pose a significant barrier to quality cancer care for some subsets of the population."

The study used discharge data from 1996-2006 for hospitals in New York, New Jersey and Pennsylvania. Patients ages 18 and over who were treated with surgery for colorectal, esophageal or pancreatic cancer were included. Over 272,000 procedures met criteria for inclusion in the study, specifically 5,273 esophageal, 13,472 pancreatic, 202,879 colon and 51,262 rectal procedures.

A shift from low volume to high volume centers occurred to varying degrees for esophageal, pancreatic and colon cancer procedures. The change was the greatest for esophageal and , which are less common than cancers of the colon and rectum. In contrast to 1996, the vast majority of procedures for these less common cancers are now performed at high volume centers.

Among the study population, travel distance increased for all patients, but more so for patients with less common cancers. For example, travel distance increased 72 percent for patients with esophageal cancer, compared to 17 percent for patients with .

"Our study demonstrated that the increase in travel distance was a direct result of the trend toward centralization at high volume centers," adds Elin Sigurdson, M.D. Ph.D., F.A.C.S., head of surgical research at Fox Chase and co-author on the study. "This study also confirms what others have found, that disparities of cancer care exist. Since disadvantaged patients are more likely to remain at low volume centers, we worry that travel may increasingly serve as a barrier for these patients, especially during tough economic times."

Source: Fox Chase Cancer Center (news : web)

Related Stories

Recommended for you

Vitamin C may encourage blood cancer stem cells to die

August 17, 2017
Vitamin C may "tell" faulty stem cells in the bone marrow to mature and die normally, instead of multiplying to cause blood cancers. This is the finding of a study led by researchers from Perlmutter Cancer Center at NYU Langone ...

Outdoor light at night linked with increased breast cancer risk in women

August 17, 2017
Women who live in areas with higher levels of outdoor light at night may be at higher risk for breast cancer than those living in areas with lower levels, according to a large long-term study from Harvard T.H. Chan School ...

Scientists develop novel immunotherapy technology for prostate cancer

August 17, 2017
A study led by scientists at The Wistar Institute describes a novel immunotherapeutic strategy for the treatment of cancer based on the use of synthetic DNA to directly encode protective antibodies against a cancer specific ...

Scientists develop blood test that spots tumor-derived DNA in people with early-stage cancers

August 16, 2017
In a bid to detect cancers early and in a noninvasive way, scientists at the Johns Hopkins Kimmel Cancer Center report they have developed a test that spots tiny amounts of cancer-specific DNA in blood and have used it to ...

Toxic formaldehyde is produced inside our own cells, scientists discover

August 16, 2017
New research has revealed that some of the toxin formaldehyde in our bodies does not come from our environment - it is a by-product of an essential reaction inside our own cells. This could provide new targets for developing ...

Cell cycle-blocking drugs can shrink tumors by enlisting immune system in attack on cancer

August 16, 2017
In the brief time that drugs known as CDK4/6 inhibitors have been approved for the treatment of metastatic breast cancer, doctors have made a startling observation: in certain patients, the drugs—designed to halt cancer ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.