National Economic Conditions May Impact the Financial Barriers to Travel for Cancer Operations

Area of Science:

• Oncology
• Health Economics
• Health Services Research

Background:

• Higher case volume hospitals are linked to better cancer outcomes.
• Complex cancer surgeries often necessitate travel to specialized, high-volume centers.
• Patient travel for cancer care is influenced by economic factors, potentially impacting access.

Purpose of the Study:

• To investigate the correlation between national economic factors and patient travel distances for cancer operations.
• To assess how economic indicators like unemployment, gas prices, and inflation affect travel for cancer care.
• To examine disparities in travel distance for cancer surgery among different socioeconomic and racial groups.

Main Methods:

• Utilized data from the National Cancer Database (2004-2017) for patients undergoing surgery for pancreatic, esophageal, breast, and skin cancers.
• Correlated patient travel distances with economic data including unemployment rates, gas prices, and inflation.
• Employed Spearman's rank-based correlation coefficient to measure associations, with P-values adjusted for multiple comparisons.

Main Results:

• Labor force participation, personal savings, consumer price index, and gasoline price changes significantly correlated with travel distances for all cancer types.
• Inflation and rising gas prices showed an inverse relationship with travel distance in lower-income, less-educated, and African American populations.
• Over 1.7 million cancer cases were analyzed, revealing complex interactions between economic indicators and patient travel behavior.

Conclusions:

• Macroeconomic factors significantly influence travel distances for cancer surgery, affecting patient access to care.
• Financially disadvantaged populations are disproportionately vulnerable to economic fluctuations impacting travel costs.
• Enhanced patient support services are crucial during economic hardship to mitigate healthcare disparities.