Related Experiment Video
Updated: Jun 11, 2025
06:03
Integrating Augmented Reality Tools in Breast Cancer Related Lymphedema Prognostication and Diagnosis
Published on: February 6, 2020
6.6K
Effect on Travel Distance of a Statewide Regionalization Policy for Initial Breast Cancer Surgery
Nina A Bickell1,2, Ann B Nattinger3,4, Emily L McGinley4
1Department of Population Health Science and Policy, Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, NY.
Summary
New York State
Area of Science:
- Health Services Research
- Oncology
- Health Economics
Background:
- Regionalization of care aims to improve patient outcomes by concentrating services at specialized centers.
- Policies restricting reimbursement for procedures at low-volume hospitals can impact patient access and travel distances.
- Understanding the effects of such policies on different insurance groups is crucial for equitable healthcare delivery.
Purpose of the Study:
- To evaluate the impact of a 2009 New York State policy on breast cancer surgery reimbursement at low-volume hospitals.
- To determine the effect of this policy on patient travel distances, particularly for Medicaid beneficiaries.
- To assess whether the policy disproportionately affected access to care based on insurance status and geographic location.
Main Methods:
- Utilized a linked dataset merging the New York State tumor registry with hospital discharge data.
- Included women under 65 with stage I-III breast tumors, comparing pre- and post-policy periods.
- Employed a multivariable difference-in-difference-in-differences model to analyze travel distance by insurance status and urbanicity.
Main Results:
- Overall, women traveled longer distances for surgery post-policy, irrespective of insurance.
- Medicaid beneficiaries consistently traveled shorter distances than non-Medicaid patients.
- Suburban Medicaid patients experienced a statistically significant, though small, increase in travel distance (+7.7 miles) compared to non-Medicaid patients post-policy.
Conclusions:
- The New York State policy regionalizing breast cancer care resulted in a statistically significant but small increase in travel distance for suburban Medicaid patients.
- The policy demonstrated improved outcomes with minimal adverse impact on overall access to care for breast cancer patients in New York.
- Findings suggest that regionalization strategies can be implemented to enhance care quality without substantially compromising patient access, with careful consideration for suburban Medicaid populations.
