Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7411, United States.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States.
JNCI Cancer Spectr. 2024 Sep 2;8(5). doi: 10.1093/jncics/pkae093.
In addition to greater delays in cancer screening and greater financial hardship, rural-dwelling cancer patients experience greater costs associated with accessing cancer care, including higher cumulative travel costs. This study aimed to identify and synthesize peer-reviewed research on the cumulative and overlapping costs associated with care access and utilization.
A scoping review was conducted to identify relevant studies published after 1995 by searching 5 electronic databases: PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycInfo, and Healthcare Administration. Eligibility was determined using the PEO (Population, Exposure, and Outcomes) method, with clearly defined populations (cancer patients), exposures (financial hardship, toxicity, or distress; travel-related burdens), and outcomes (treatment access, treatment outcomes, health-related quality of life, and survival/mortality). Study characteristics, methods, and findings were extracted and summarized.
Database searches yielded 6439 results, of which 3366 were unique citations. Of those, 141 were eligible for full-text review, and 98 studies at the intersection of cancer-related travel burdens and financial hardship were included. Five themes emerged as we extracted from the full texts of the included articles: 1) Cancer treatment choices, 2) Receipt of guideline-concordant care, 3) Cancer treatment outcomes, 4) Health-related quality of life, and 5) Propensity to participate in clinical trials.
This scoping review identifies and summarizes available research at the intersection of cancer care-related travel burdens and financial hardship. This review will inform the development of future interventions aimed at reducing the negative effects of cancer-care related costs on patient outcomes and quality of life.
除了癌症筛查的延迟时间更长、经济困难更大之外，农村地区的癌症患者在获得癌症治疗方面还面临着更高的费用，包括更高的累计旅行费用。本研究旨在确定并综合评估与获得和利用癌症护理相关的累计和重叠费用的同行评议研究。
本研究采用范围综述方法，通过搜索 5 个电子数据库（PubMed、Scopus、护理与健康相关文献累积索引（CINAHL）、PsycInfo 和医疗保健管理），确定了 1995 年后发表的相关研究。使用 PEO（人群、暴露和结局）方法确定纳入标准，其中明确界定了人群（癌症患者）、暴露（经济困难、毒性或压力；与旅行相关的负担）和结局（治疗获得、治疗结果、健康相关生活质量和生存/死亡率）。提取并总结了研究特征、方法和结果。
数据库搜索产生了 6439 项结果，其中 3366 项为唯一引用。在这些结果中，有 141 项符合全文审查标准，最终纳入了 98 项与癌症相关旅行负担和经济困难交叉的研究。从纳入文章的全文中提取出了 5 个主题：1）癌症治疗选择；2）接受符合指南的护理；3）癌症治疗结果；4）健康相关生活质量；5）参与临床试验的倾向。
本范围综述确定并总结了与癌症治疗相关的旅行负担和经济困难交叉领域的现有研究。本综述将为未来旨在减少癌症护理相关成本对患者结局和生活质量的负面影响的干预措施的制定提供信息。
