Access to Care and Healthcare Quality Metrics for Patients with Advanced Genitourinary Cancers in Urban versus Rural Areas
Compared to the urban population, patients in rural areas face healthcare disparities and experience inferior healthcare-related outcomes. To compare the healthcare quality metrics and outcomes between patients with advanced genitourinary cancers from rural versus urban areas treated at a tertiary c...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/15/21/5171 |
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| author | Haoran Li Kamal Kant Sahu Shruti Adidam Kumar Nishita Tripathi Nicolas Sayegh Blake Nordblad Beverly Chigarira Sumati Gupta Benjamin L. Maughan Neeraj Agarwal Umang Swami |
| author_facet | Haoran Li Kamal Kant Sahu Shruti Adidam Kumar Nishita Tripathi Nicolas Sayegh Blake Nordblad Beverly Chigarira Sumati Gupta Benjamin L. Maughan Neeraj Agarwal Umang Swami |
| author_sort | Haoran Li |
| collection | DOAJ |
| description | Compared to the urban population, patients in rural areas face healthcare disparities and experience inferior healthcare-related outcomes. To compare the healthcare quality metrics and outcomes between patients with advanced genitourinary cancers from rural versus urban areas treated at a tertiary cancer hospital, in this retrospective study, eligible patients with advanced genitourinary cancers were treated at Huntsman Cancer Institute, an NCI-Designated Comprehensive Cancer Center in Utah. Rural–urban commuting area codes were used to classify the patients’ residences as being in urban (1–3) or rural (4–10) areas. The straight line distances of the patients’ residences from the cancer center were also calculated and included in the analysis. The median household income data were obtained and calculated from “The Michigan Population Studies Center”, based on individual zip codes. In this study, 2312 patients were screened, and 1025 eligible patients were included for further analysis (metastatic prostate cancer (<i>n</i> = 679), metastatic bladder cancer (<i>n</i> = 184), and metastatic renal cell carcinoma (<i>n</i> = 162). Most patients (83.9%) came from urban areas, while the remainder were from rural areas. Both groups had comparable demographic profiles and tumor characteristics at baseline. The annual median household income of urban patients was $8604 higher than that of rural patients (<i>p</i> < 0.001). There were fewer urban patients with Medicare (44.9% vs. 50.9%) and more urban patients with private insurance (40.4% vs. 35.1%). There was no difference between the urban and rural patients regarding receiving systemic therapies, enrollment in clinical trials, or tumor genomic profiling. The overall survival rate was not significantly different between the two populations in metastatic prostate, bladder, and kidney cancer, respectively. As available in a tertiary cancer hospital, access to care can mitigate the difference in the quality of healthcare and clinical outcomes in urban versus rural patients. |
| first_indexed | 2024-03-11T11:33:07Z |
| format | Article |
| id | doaj.art-eaf7be66ca8d4829a72627d403ed9483 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T11:33:07Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-eaf7be66ca8d4829a72627d403ed94832023-11-10T15:00:07ZengMDPI AGCancers2072-66942023-10-011521517110.3390/cancers15215171Access to Care and Healthcare Quality Metrics for Patients with Advanced Genitourinary Cancers in Urban versus Rural AreasHaoran Li0Kamal Kant Sahu1Shruti Adidam Kumar2Nishita Tripathi3Nicolas Sayegh4Blake Nordblad5Beverly Chigarira6Sumati Gupta7Benjamin L. Maughan8Neeraj Agarwal9Umang Swami10Division of Medical Oncology, University of Kansas Cancer Center, Westwood, KS 66205, USADivision of Oncology, Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADepartment of Internal Medicine, University of Connecticut, Farmington, CT 06030, USADepartment of Internal Medicine, Wayne State University, Detroit, MI 48202, USADepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75235, USADivision of Oncology, Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USADivision of Oncology, Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USACompared to the urban population, patients in rural areas face healthcare disparities and experience inferior healthcare-related outcomes. To compare the healthcare quality metrics and outcomes between patients with advanced genitourinary cancers from rural versus urban areas treated at a tertiary cancer hospital, in this retrospective study, eligible patients with advanced genitourinary cancers were treated at Huntsman Cancer Institute, an NCI-Designated Comprehensive Cancer Center in Utah. Rural–urban commuting area codes were used to classify the patients’ residences as being in urban (1–3) or rural (4–10) areas. The straight line distances of the patients’ residences from the cancer center were also calculated and included in the analysis. The median household income data were obtained and calculated from “The Michigan Population Studies Center”, based on individual zip codes. In this study, 2312 patients were screened, and 1025 eligible patients were included for further analysis (metastatic prostate cancer (<i>n</i> = 679), metastatic bladder cancer (<i>n</i> = 184), and metastatic renal cell carcinoma (<i>n</i> = 162). Most patients (83.9%) came from urban areas, while the remainder were from rural areas. Both groups had comparable demographic profiles and tumor characteristics at baseline. The annual median household income of urban patients was $8604 higher than that of rural patients (<i>p</i> < 0.001). There were fewer urban patients with Medicare (44.9% vs. 50.9%) and more urban patients with private insurance (40.4% vs. 35.1%). There was no difference between the urban and rural patients regarding receiving systemic therapies, enrollment in clinical trials, or tumor genomic profiling. The overall survival rate was not significantly different between the two populations in metastatic prostate, bladder, and kidney cancer, respectively. As available in a tertiary cancer hospital, access to care can mitigate the difference in the quality of healthcare and clinical outcomes in urban versus rural patients.https://www.mdpi.com/2072-6694/15/21/5171healthcaredisparitycancergenitourinary malignancyruralurban |
| spellingShingle | Haoran Li Kamal Kant Sahu Shruti Adidam Kumar Nishita Tripathi Nicolas Sayegh Blake Nordblad Beverly Chigarira Sumati Gupta Benjamin L. Maughan Neeraj Agarwal Umang Swami Access to Care and Healthcare Quality Metrics for Patients with Advanced Genitourinary Cancers in Urban versus Rural Areas Cancers healthcare disparity cancer genitourinary malignancy rural urban |
| title | Access to Care and Healthcare Quality Metrics for Patients with Advanced Genitourinary Cancers in Urban versus Rural Areas |
| title_full | Access to Care and Healthcare Quality Metrics for Patients with Advanced Genitourinary Cancers in Urban versus Rural Areas |
| title_fullStr | Access to Care and Healthcare Quality Metrics for Patients with Advanced Genitourinary Cancers in Urban versus Rural Areas |
| title_full_unstemmed | Access to Care and Healthcare Quality Metrics for Patients with Advanced Genitourinary Cancers in Urban versus Rural Areas |
| title_short | Access to Care and Healthcare Quality Metrics for Patients with Advanced Genitourinary Cancers in Urban versus Rural Areas |
| title_sort | access to care and healthcare quality metrics for patients with advanced genitourinary cancers in urban versus rural areas |
| topic | healthcare disparity cancer genitourinary malignancy rural urban |
| url | https://www.mdpi.com/2072-6694/15/21/5171 |
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