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瑞士儿科肿瘤中心的可及性:农村-城市和瑞士-外国人队列之间的差异。

Access to paediatric oncology centres in Switzerland: Disparities across rural-urban and Swiss-foreigners cohorts.

机构信息

Institute of Geography and Geology, University of Würzburg, Würzburg, Germany.

Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.

出版信息

Eur J Cancer Care (Engl). 2022 Nov;31(6):e13679. doi: 10.1111/ecc.13679. Epub 2022 Aug 9.

Abstract

OBJECTIVE

In face of disparities in access to cancer care, it has been proposed to measure accessibility and to explore policy strategies for mitigating inequality of access. We aimed to determine the accessibility of Swiss paediatric oncology centres.

METHODS

We employed spatial accessibility analysis, calculating driving time to nearest facility. Four data types were used: disaggregated population data, administrative data, street network data and addresses of centres. Besides analysing general accessibility, we compared access of urban versus rural areas and of Swiss citizens versus foreign residents and evaluated designating a new centre to improve accessibility.

RESULTS

Overall, 97.4% could reach the nearest centre within 120 min (95.0% < 90 min, 86.5% < 60 min, 48.5% < 30 min). Accessibility could most effectively be improved by a new centre in Sion (city in the southwest of Switzerland). Access in urban areas was better than in rural areas. In urban areas, access of European Union/European Free Trade Association (EU/EFTA) and non-European residents was better than access of Swiss citizens and residents from non-EU European countries.

CONCLUSION

Access is satisfactory. However, our study presents high-resolution insights which could serve as points of leverage for policymakers to mitigate inequalities by designating a new centre and to evaluate potential benefits of centralisation.

摘要

目的

面对癌症治疗机会不均等的问题,人们提出了衡量可达性的概念,并探索了减轻获取机会不平等的政策策略。本研究旨在确定瑞士儿科肿瘤中心的可达性。

方法

我们采用空间可达性分析方法,计算到最近医疗机构的驾驶时间。使用了四种数据类型:人口细分数据、行政数据、街道网络数据和中心地址。除了分析一般可达性外,我们还比较了城市与农村地区、瑞士公民与外国居民的可达性,并评估了指定一个新中心以提高可达性的效果。

结果

总体而言,97.4%的人可以在 120 分钟内到达最近的中心(95.0%<90 分钟,86.5%<60 分钟,48.5%<30 分钟)。在锡永(瑞士西南部的一个城市)新建一个中心可以最有效地提高可达性。城市地区的可达性优于农村地区。在城市地区,欧盟/欧洲自由贸易区(EU/EFTA)和非欧洲居民的可达性优于瑞士公民和来自非欧盟欧洲国家的居民。

结论

可达性令人满意。然而,我们的研究提供了高分辨率的见解,可以作为政策制定者的杠杆点,通过指定一个新的中心来减轻不平等,并评估集中化的潜在好处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b31a/9788087/9cf3375dcf15/ECC-31-e13679-g002.jpg

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