Hospital Accreditation and Geographic Disparities in Timely Cancer Care

Area of Science:

• Oncology
• Health Services Research
• Health Equity

Background:

• Accreditation of cancer care facilities aims to standardize quality.
• Timely treatment initiation is crucial for cancer patient outcomes.
• Socioeconomic factors may influence access to timely cancer care.

Purpose of the Study:

• To investigate if hospital accreditation impacts timely cancer treatment initiation.
• To determine if this association differs based on county income levels.

Main Methods:

• Cross-sectional study analyzing Surveillance, Epidemiological, and End Results (SEER) data (2018-2021).
• Compared time from diagnosis to treatment initiation between accredited and non-accredited hospitals.
• Stratified analyses by county median household income (low <$80k, high ≥$80k).
• Used quantile regression, adjusting for patient and tumor characteristics.

Main Results:

• Care at accredited hospitals was linked to a 2.6-day increase in median time-to-treatment in low-income counties, but not high-income counties.
• Accreditation widened the time-to-treatment range in low-income counties.
• These effects were more pronounced in older patients, unmarried individuals, and those with early-stage or rare cancers.
• Accreditation reduced treatment time for distant-stage cancers in both income groups.

Conclusions:

• Accredited hospitals may exacerbate treatment time disparities between high- and low-income counties.
• Access barriers for low-income cancer patients likely contribute to these delays.
• Health systems must address these disparities to ensure equitable and timely cancer care.
• Further research is needed to understand and mitigate delays for patients in lower-resource communities.