Springfield, Ill., November 16, 2011 – A unique team of
epidemiologists, central registrars, geographers and spatial scientists has
developed a tool that may lead to a better understanding of the decisions
people make when accessing health care.
A new tool developed by researchers at USC Spatial Science Institute, and the North American
Association of Central Cancer Registries(NAACCR) through funding by Susan G. Komen for the Cure, sheds new light
on trends related to travel distances to health care and geographic barriers to
care.
“Traditionally, the thinking among
researchers is that longer travel distance to clinics might be a barrier to
access to care. However, what researchers are finding is that trends are
changing,” said team member and University of Southern California (USC) spatial scientist Dan Goldberg. “People are
bypassing closer hospitals for farther ones. The studies performed during this
project show that the role of geography is changing and that other variables
such as insurance may be impacting access to care as well.”
This tool is now available online and
Kevin Henry, team member and Assistant Professor of Geography at the University
of Utah, said it will be useful in many aspects of geographic research as it
relates to access to health services.
“Surprisingly, we know little about how
far people travel to different types of health services or what type of disparities
in geographic access exist.The
shortest path tool combined with a growing number of databases containing the
geographic location of physicians and health facilities should aid researchers
and public health practitioners in assessing geographic access to both health care
and preventative services,” said Henry.
The tool, a web-based automated
processing framework to be used for cancer-related research, has successfully
been tested and used within two nationwide studies involving ten
population-based state cancer registries. Using breast cancer as the focus, the
studies investigated the links between travel distance and important breast
cancer diagnosis and treatment endpoints. The purpose of the first study was to assess
the relationship between breast cancer surgery and geographic access to
radiation therapy, and the second study investigated whether travel time to a
patient’s diagnosing facility or nearest mammography facility impacted breast
cancer stage at diagnosis.
“We’ve gained a better understanding of
how the distance to a treatment center affects quality of care,” said team
member andNew York State Cancer
Registry research scientist Francis Boscoe, adding geography still matters, but
not to the same degree it was previously thought. “Results from these studies showed
women in inner city areas now have poorer access than those who live far from a
medical facility. Given that the rural-urban gradient has been lessened,
driving distance is no longer a major part of understanding or reducing
disparities. I think it has more to do with things like insurance,
socioeconomic status, hospital practices, and referral networks.”
Funded by a generous grant from Komen
for the Cure® and made possible by a donation of street reference files from
NAVTEQ, Inc.®, the NAACCR/Komen/USC
Shortest Path tool is offered as a free service to the greater NAACCR community
for use in cancer-related research. The goal of this project is to provide
researchers with ready access to the data necessary to study the effects of
geography on issues related to cancer prevention, diagnosis, and treatment.
Betsy Kohler, Executive Director of
NAACCR pointed out that “A key goal of NAACCR is to promote the use of cancer
surveillance data and systems for cancer control.This project clearly illustrates the power of
cancer registry data for new and innovative research.”
Established in 1987, the North American
Association of Central Cancer Registries, Inc. (NAACCR), is a collaborative
umbrella organization for cancer registries, governmental agencies,
professional organizations, and private groups in North America interested in enhancing the quality and use of
cancer registry data. Its goal is to set standards and build consensus for the
collection of uniform cancer data across the continent. All state and
provincial central cancer registries in the United States and Canada
are members.