Walker Blake Byron, Schuurman Nadine, Auluck Ajit, Lear Scott A, Rosin Miriam
Simon Fraser University, Burnaby, British Columbia, Canada.
British Columbia Cancer Research Centre, Vancouver, British Columbia, Canada.
Rural Remote Health. 2017 Jul-Sep;17(3):4210. doi: 10.22605/RRH4210. Epub 2017 Aug 31.
Both socioeconomic status and travel time to cancer treatment have been associated with treatment choice and patient outcomes. An improved understanding of the relationship between these two dimensions of access may enable cancer control experts to better target patients with poor access, particularly in isolated suburban and rural communities.
Using geographical information systems, head and neck cancer patients across British Columbia, Canada from 1981 to 2009, were mapped and their travel times to the nearest treatment center at their time of diagnosis were modelled. Patients' travel times were analysed by urban, suburban, and rural neighborhood types and an index of multiple socioeconomic deprivation was used to assess the role of socioeconomic status in patients' spatial access.
Significant associations between socioeconomic deprivation and spatial access to treatment were identified, with the most deprived quintiles of patients experiencing nearly twice the travel time as the least deprived quintile. The sharpest disparities were observed among the most deprived patient populations in suburban and rural areas. However, the establishment of new treatment centers has decreased overall travel times by 28% in recent decades.
Residence in a neighborhood with high socioeconomic deprivation is strongly associated with head and neck cancer patients' spatial access to cancer treatment centers. Patients residing in the most socioeconomically deprived neighborhoods consistently have longer travel times in urban, suburban, and rural communities in the study area.
社会经济地位和前往癌症治疗机构的出行时间均与治疗选择及患者治疗结果相关。深入了解这两个就医维度之间的关系，或许能使癌症防治专家更精准地关注就医不便的患者，尤其是在偏远的城郊和农村社区。
利用地理信息系统，对1981年至2009年加拿大不列颠哥伦比亚省的头颈癌患者进行地理定位，并模拟他们在确诊时前往最近治疗中心的出行时间。按城市、城郊和农村社区类型分析患者的出行时间，并使用多重社会经济剥夺指数评估社会经济地位在患者空间就医方面的作用。
确定了社会经济剥夺与就医空间可达性之间存在显著关联，最贫困五分位数患者的出行时间几乎是最不贫困五分位数患者的两倍。在城郊和农村地区最贫困的患者群体中，差距最为明显。然而，近几十年来新治疗中心的设立使总体出行时间减少了28%。
居住在社会经济剥夺程度高的社区与头颈癌患者就医的空间可达性密切相关。在研究区域内，居住在社会经济最贫困社区的患者，在城市、城郊和农村社区的出行时间始终较长。
