Geospatial Analysis of Commission on Cancer-Accredited Centers Within Cancer Care Utilization-Based Catchment Areas

Area of Science:

• Oncology
• Health Services Research
• Geographic Information Systems (GIS) in Public Health

Background:

• The Commission on Cancer (CoC) aims to improve cancer care quality through community engagement and accreditation.
• Understanding the characteristics of CoC-accredited centers' catchment areas is crucial for assessing their impact.
• Cancer Service Areas (CSAs) based on patient flow data offer a novel way to define these catchment areas.

Purpose of the Study:

• To compare the social, environmental, and geographic characteristics of Cancer Service Areas (CSAs) with and without CoC-accredited centers.
• To identify factors associated with the presence of a CoC-accredited center within a CSA.

Main Methods:

• Delineated CSAs using Medicare claims data and a spatially constrained community detection method.
• Aggregated characteristics including Environmental Justice Index (EJI), Social Vulnerability Index (SVI), rurality, travel time, and localization index (LI).
• Employed logistic regression to assess factors associated with CoC-accredited center presence.

Main Results:

• 668 CSAs were identified; 511 contained at least one CoC-accredited center.
• CSAs with CoC-accredited centers exhibited lower health vulnerability (OR 0.65) and racial/ethnic minority vulnerability (OR 0.61).
• These CSAs also demonstrated higher localization indices (OR 9.00), indicating patients received care locally.

Conclusions:

• CoC-accredited centers are located in areas with lower overall vulnerability but may not fully serve minority and comorbid populations.
• Disparities in cancer care access may persist, potentially worsening cancer outcome variations.
• Expanding outreach to at-risk catchment areas is recommended for CoC-accredited centers.