Eala Michelle Ann B, Maslog Ethan Angelo S, Alberto Nicole Rose I, Alberto Isabelle Rose I, Ho Frances Dominique V, Dee Edward Christopher, Raldow Ann, Cereno Reno Eufemon
College of Medicine, University of the Philippines, Manila, Philippines.
Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California.
Adv Radiat Oncol. 2024 Dec 7;10(2):101699. doi: 10.1016/j.adro.2024.101699. eCollection 2025 Feb.
Travel burden negatively impacts the stage at diagnosis, treatment, outcome, and quality of life among patients with cancer. Travel burden-quantified as distance, time, and cost of travel-is magnified in low- and middle-income countries like the Philippines, where radiation therapy (RT) resources are lacking and are inequitably distributed.
We compared Philippine Radiation Oncology Society data and the population census to determine the distribution and density of RT facilities across the country's 17 regions. For distance and travel time, we used the Google Maps route planner to determine the best routes from each province to the nearest private and government RT facility. Travel cost was calculated by multiplying distance by the local price of diesel per liter and the mean fuel economy of passenger vehicles in the Philippines.
There are only 54 RT facilities in the Philippines (0.5 per 1 million population). More than a third are in the National Capital Region (NCR). Four regions do not have an RT facility. Nationally, the average distance to any RT facility is 101.02 km with a travel time of 2.66 hours and a travel cost of PHP 4811.11 ($85.91). Travel burden to any RT facility is the least in NCR and greatest in Visayas. Travel burden to a government RT facility is greater, with an average distance of 136.94 km, travel time of 3.05 hours, and travel cost of PHP 6353.43 ($113.45). Travel burden to a government RT facility is least in NCR and greatest in Mindanao.
The travel burden of RT in the Philippines is significant and varies regionally and by RT facility type (private or government). Data-driven installation of government RT facilities in underserved regions, alternative reimbursement systems to encourage hypofractionation when appropriate, patient subsidies for housing/transportation while on treatment, better public transportation, and patient navigation are needed.
就医负担对癌症患者的诊断阶段、治疗、预后及生活质量产生负面影响。在菲律宾等低收入和中等收入国家，就医负担（以行程距离、时间和费用衡量）因放疗资源匮乏且分布不均而加剧。
我们比较了菲律宾放射肿瘤学会的数据和人口普查数据，以确定放疗设施在该国17个地区的分布和密度。对于距离和出行时间，我们使用谷歌地图路线规划器来确定从每个省份到最近的私立和政府放疗设施的最佳路线。出行成本通过将距离乘以当地每升柴油价格和菲律宾乘用车的平均燃油经济性来计算。
菲律宾仅有54个放疗设施（每百万人口0.5个）。超过三分之一位于国家首都地区（NCR）。有四个地区没有放疗设施。在全国范围内，到任何放疗设施的平均距离为101.02公里，出行时间为2.66小时，出行成本为4811.11菲律宾比索（85.91美元）。到任何放疗设施的就医负担在NCR最轻，在米沙鄢群岛最重。到政府放疗设施的就医负担更大，平均距离为136.94公里，出行时间为3.05小时，出行成本为6353.43菲律宾比索（113.45美元）。到政府放疗设施的就医负担在NCR最轻，在棉兰老岛最重。
菲律宾放疗的就医负担很大，且因地区和放疗设施类型（私立或政府）而异。需要以数据为驱动，在服务不足地区安装政府放疗设施，采用替代报销系统以在适当时候鼓励大分割放疗，为患者在治疗期间的住房/交通提供补贴，改善公共交通，并为患者提供导航服务。
