Journal article
Identification of underserved areas for urologic cancer care
Cancer, Vol.120(10), pp.1565-1571
05/15/2014
Handle:
https://hdl.handle.net/2376/114346
PMCID: PMC4237218
PMID: 24523042
Abstract
BACKGROUND
The delivery of urologic oncology care is susceptible to regional variation. In the current study, the authors sought to define patterns of care for patients undergoing genitourinary cancer surgery to identify underserved areas for urologic cancer care in Washington State.
METHODS
The authors accessed the Washington State Comprehensive Hospital Reporting System from 2003 through 2007. They identified patients undergoing radical prostatectomy, radical cystectomy (RC), partial nephrectomy (PN), radical nephrectomy, and transurethral resection of the prostate (TURP). TURP was included for comparison as a reference procedure indicative of access to urologic care. Hospital service areas (HSAs) are where the majority of local patients are hospitalized; hospital referral regions (HRR) are where most patients receive tertiary care. The authors created multivariate hierarchical logistic regression models to examine patient and HSA characteristics associated with the receipt of urologic oncology care out of the HRR for each procedure.
RESULTS
Greater than one‐half of patients went out of their HRR in 7 HSAs (11%) for radical prostatectomy, 3 HSAs (5%) for radical nephrectomy, 10 HSAs (15%) for PN, and 14 HSAs (22%) for RC. No HSAs had high export rates for TURP. Few patient factors were found to be associated with surgical care out of the HRR. High‐export HSAs for PN and RC exhibited lower socioeconomic characteristics than low‐export HSAs, adjusting for HSA population, race, and HSA procedure rates for PN and RC.
CONCLUSIONS
Patients living in areas with lower socioeconomic status have a greater need to travel for complex urologic surgery. Consideration of geographic delineation in the delivery of urologic oncology care may aid in regional quality improvement initiatives. Cancer 2014;120:1565–1571. © 2014 American Cancer Society.
Patients who require complex oncologic surgery may face greater burdens of travel and have less access to care. Patients of older age, with increased comorbidities, and of lower socioeconomic status face challenges obtaining complex urologic cancer care.
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Details
- Title
- Identification of underserved areas for urologic cancer care
- Creators
- Matthew Mossanen - University of WashingtonJason Izard - Queen's UniversityJonathan L Wright - University of WashingtonJonathan D Harper - University of WashingtonMichael P Porter - Puget Sound Veteran Affairs Health Care SystemKenn B Daratha - Washington State University College of NursingSarah K Holt - University of WashingtonJohn L Gore - University of Washington
- Publication Details
- Cancer, Vol.120(10), pp.1565-1571
- Number of pages
- 9
- Identifiers
- 99900548053001842
- Language
- English
- Resource Type
- Journal article