ArticleAnnals of surgical oncology2023
Variations in Travel Patterns Affect Regionalization of Complex Cancer Surgery in California.
Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Within-Region Versus Out-of-Region Cancer Care: Healthcare Patterns and Clinical Outcomes in South Korea.Cancers · 2026Article
- Gravity Modeling to Predict Patient Choice of Hospital for Pancreaticoduodenectomy.Annals of surgical oncology · 2026Article
- Patterns of Referral for Common Cancer Surgery in the United States.Annals of surgical oncology · 2025Article
- Associations of Social Vulnerability and Race-Ethnicity With Gastrointestinal Cancers in the United States.Cancer medicine · 2025Article
- Association of Hospital Market Competition with Outcomes of Complex Cancer Surgery.Annals of surgical oncology · 2024Article
- Variation in Hospital Mortality After Complex Cancer Surgery: Patient, Volume, Hospital or Social Determinants?Annals of surgical oncology · 2024Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionRegionalization of complex surgical procedures may improve healthcare quality. We sought to define the impact of regionalization on access to high-volume hospitals for complex oncologic procedures in the state of California.
methodsThe California Department of Health Care Access and Information Database (2012-2016) identified patients who underwent esophagectomy (ES), pneumonectomy (PN), pancreatectomy (PA), or proctectomy (PR). Geospatial analysis was conducted to determine travel patterns. Clustered multivariable regression was performed to assess the probability of receiving care at a high-volume center.
resultsAmong 25,070 patients (ES: n = 1216, 4.9%; PN: n = 13,247, 52.8%; PD: n = 3559, 14.2%; PR: n = 7048, 28.1%), 6575 (26.2%) individuals resided within 30 min, 11,046 (44.1%) resided within 30-60 min, 7125 (28.4%) resided within 60-90 min, and 324 (1.3%) resided beyond a 90-min travel window from a high-volume center. Median travel distance was 13.4 miles (interquartile range [IQR] 6.0-28.7). On multivariable regression, patients residing further away were more likely to bypass a low-volume center to undergo care at a high-volume hospital (odds ratio 1.32, 95% confidence interval 1.12-1.55) versus individuals residing closer to high-volume centers. Approximately one-third (29.7%) of patients lived beyond a 1-h travel window to the nearest high-volume hospital, of whom 5% traveled over 90 min. While hospital mortality rates across different travel time windows did not differ, surgery at a high-volume center was associated with an overall 1.2% decrease in in-hospital mortality.
conclusionsRegionalization of complex cancer surgery may be associated with a significant travel burden for a large subset of patients with complex cancer.
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