Geographic disparities in access to cancer care: do patients in outlying areas talk about their access problems to their general practitioners and medical oncologists and how does that impact on the choice of chemotherapy?

Abstract

Geographic disparities in access to cancer care have been reported for several countries. The distance between the place of residence and the cancer care centre can be one cause of these disparities. Solutions to surmount the barriers can be found if patients talk about this to their care professionals. We investigated whether patients in Valais talk with their physicians about difficulties to access cancer care. We interviewed five general practitioners and five medical oncologists in Valais with semi-structured interviews to identify difficulties patients are talking about. Medical oncologists were also interviewed on their habits to adapt chemotherapy to access problems of their patients. Cancer patients in Valais do talk about their access problems. Medical oncologists in Valais do take access problems into account when discussing therapeutic options with the patients and use the scope they have within their therapeutic options. In Valais the family of cancer patients play an important role in access to cancer care. Special offers are in place when social support is insufficient. Whether some socio-economic minorities do not use the solutions in place cannot be answered and should be investigated in further studies.

How Do Gender, Age and Travel Time Impact on the Need for Social Support of Patients to Have Access to Cancer Treatment?

“…A former study disclosed transport issues as a major obstacle to cancer treatment for elderly patients (S. Anchisi & A. Anchisi, 2008). These results have been confirmed by a recent study which also demonstrated that cancer patients in Valais outline this issue when discussing cancer treatment with their general practitioner and medical oncologist (Groux & Szucs, 2013). Free transport services for patients who need help are offered by the local cancer league: volunteers drive the patients of the French speaking part in their private car and for radio-oncology patients of the German speaking part a daily bus starting in Brig and stopping at each railway station drives the patients to Sion, where a special time slot is reserved for them.…”

Physician‐reported barriers to referring cancer patients to specialists: Prevalence, factors, and association with career satisfaction

“…However, in our study, excessive travel time was not reported to be an important barrier to specialist referral. Although this finding may reflect poor communication between clinicians and patients, evidence shows that distance issues are sufficiently discussed, and this suggests that our finding is valid.…”

Cancer Patient’s Contribution to Reduce Chemotherapy Related Burden of Travel: What Would Chemotherapy Patients Agree to Do?

“…Haematological cancer survivors living in a nonmetropolitan location are reported to have 17 times the odds of reporting locational or financial barriers compared to survivors leaving in a metropolitan area [6]. Cancer patients address access problems as well with their general practitioners as with their medical oncologists [7]. The use of the less travelling intensive hypofractionated breast radiotherapy versus conventional breast radiotherapy is correlated with the distance to the clinic [8].…”