Association Between Distance to Care and Nonmedical Costs Among Families of Children With Cancer

Families of children with cancer often incur substantial nonmedical costs for travel, lodging, and food when accessing specialized care. These costs can contribute to health-related financial strain, yet the relationship between distance to care and nonmedical costs remains poorly understood.

We conducted a retrospective cohort study of families applying for support from Children's Cancer Partners of the Carolinas (CCPC) between August 2011 and March 2024. Eligible participants included families of children with cancer from North and South Carolina with complete data on zip code, treatment center, and reimbursed costs. Distance to the primary treatment center was calculated in miles and minutes. Outcomes included total nonmedical costs (USD) and the frequency, magnitude, and types of reimbursed costs.

Among 1890 children, the mean age was 10.4 years (SD 5.4), most were male (56%), White (51%), and publicly insured (56%). The most common diagnosis was hematologic malignancy (49%). One-fifth (22%) lived in rural areas. Median nonmedical costs were $1094/family (interquartile range [IQR]: $320-2379), and represent costs of land travel, food, and leisure. Median travel distance was 37.8 miles [IQR: 21.3-71.4] or 46.9 min [IQR: 31.0-81.3] each way. After adjusting for potential confounders, each additional travel minute was associated with $9.14 higher nonmedical costs (95% confidence interval [CI]: 6.91-11.37), and each additional mile was associated with $8.85 higher costs (95% CI: 6.69-11.00).

Longer distance to cancer care is associated with increased total nonmedical costs. Additional resources may help reduce travel-related costs for families living far from pediatric cancer centers.