Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment
Abstract Background Greater travel time to cancer care has been identified as a potential barrier to care as well as associated with worse health outcomes. While rural cancer patients have been shown to travel farther for care, it is not known what patient, facility, and clinical characteristics may...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-02-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-020-8282-z |
| _version_ | 1818451538631196672 |
|---|---|
| author | Joel E. Segel Eugene J. Lengerich |
| author_facet | Joel E. Segel Eugene J. Lengerich |
| author_sort | Joel E. Segel |
| collection | DOAJ |
| description | Abstract Background Greater travel time to cancer care has been identified as a potential barrier to care as well as associated with worse health outcomes. While rural cancer patients have been shown to travel farther for care, it is not known what patient, facility, and clinical characteristics may differentially be associated with greater roundtrip travel times for cancer patients by rurality of residence. Identifying these factors will help providers understand which patients may be most in need of resources to assist with travel. Methods Using 2010–2014 Pennsylvania Cancer Registry data, we examined the association between patient, facility, and clinical characteristics with roundtrip patient travel time using multivariate linear regression models. We then estimated separate models by rural residence based on the Rural-Urban Continuum Code (RUCC) of a patient’s county of residence at diagnosis to understand how the association of each factor with travel time may vary for patients separated into metro residents (RUCC 1–3); and two categories of non-metro residents (RUCC 4–6) and (RUCC 7–9). Results In our sample (n = 197,498), we document large differences in mean roundtrip travel time—mean 41.5 min for RUCC 1–3 patients vs. 128.9 min for RUCC 7–9 patients. We show cervical/uterine and ovarian cancer patients travel significantly farther; as do patients traveling to higher volume and higher-ranked hospitals. Conclusions To better understand patient travel burden, providers need to understand that factors predicting longer travel time may vary by rurality of patient residence and cancer type. |
| first_indexed | 2024-12-14T21:08:48Z |
| format | Article |
| id | doaj.art-ce8b1b8c748b4b1a85ccacf954716046 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-14T21:08:48Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-ce8b1b8c748b4b1a85ccacf9547160462022-12-21T22:47:19ZengBMCBMC Public Health1471-24582020-02-0120111010.1186/s12889-020-8282-zRural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatmentJoel E. Segel0Eugene J. Lengerich1Department of Health Policy and Administration, Pennsylvania State UniversityPenn State Cancer InstituteAbstract Background Greater travel time to cancer care has been identified as a potential barrier to care as well as associated with worse health outcomes. While rural cancer patients have been shown to travel farther for care, it is not known what patient, facility, and clinical characteristics may differentially be associated with greater roundtrip travel times for cancer patients by rurality of residence. Identifying these factors will help providers understand which patients may be most in need of resources to assist with travel. Methods Using 2010–2014 Pennsylvania Cancer Registry data, we examined the association between patient, facility, and clinical characteristics with roundtrip patient travel time using multivariate linear regression models. We then estimated separate models by rural residence based on the Rural-Urban Continuum Code (RUCC) of a patient’s county of residence at diagnosis to understand how the association of each factor with travel time may vary for patients separated into metro residents (RUCC 1–3); and two categories of non-metro residents (RUCC 4–6) and (RUCC 7–9). Results In our sample (n = 197,498), we document large differences in mean roundtrip travel time—mean 41.5 min for RUCC 1–3 patients vs. 128.9 min for RUCC 7–9 patients. We show cervical/uterine and ovarian cancer patients travel significantly farther; as do patients traveling to higher volume and higher-ranked hospitals. Conclusions To better understand patient travel burden, providers need to understand that factors predicting longer travel time may vary by rurality of patient residence and cancer type.https://doi.org/10.1186/s12889-020-8282-zRural-urban disparitiesHealth services accessibilityRural health servicesCancerTravel time |
| spellingShingle | Joel E. Segel Eugene J. Lengerich Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment BMC Public Health Rural-urban disparities Health services accessibility Rural health services Cancer Travel time |
| title | Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment |
| title_full | Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment |
| title_fullStr | Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment |
| title_full_unstemmed | Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment |
| title_short | Rural-urban differences in the association between individual, facility, and clinical characteristics and travel time for cancer treatment |
| title_sort | rural urban differences in the association between individual facility and clinical characteristics and travel time for cancer treatment |
| topic | Rural-urban disparities Health services accessibility Rural health services Cancer Travel time |
| url | https://doi.org/10.1186/s12889-020-8282-z |
| work_keys_str_mv | AT joelesegel ruralurbandifferencesintheassociationbetweenindividualfacilityandclinicalcharacteristicsandtraveltimeforcancertreatment AT eugenejlengerich ruralurbandifferencesintheassociationbetweenindividualfacilityandclinicalcharacteristicsandtraveltimeforcancertreatment |