Optimal Location of Radiation Therapy Centers With Respect to Geographic Access

Santibáñez, Pablo; Gaudet, Marc; French, John; Liu, Emma; Tyldesley, Scott

doi:10.1016/j.ijrobp.2014.04.011

Cited by 14 publications

(10 citation statements)

References 14 publications

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“…The present study is the first study to report accessibility of radiotherapy facilities in Malaysia based on the distance and travel time. Despite previous reports made on quantification of accessibility in different geographical distributions and populations in North Queensland [15] and British Columbia [16], no previous data was available on accessibility of radiotherapy in Malaysia. We found that, on average, Malaysia population needs to travel a large distance to access radiotherapy facility.…”

Section: Discussionmentioning

confidence: 99%

“…In the East Coast region where the number of MV units per million is low, the installation of a new centre may be appropriate to reduce the distance and travel time for the region. To determine the optimal location, Santibanez et al have proposed a data-driven mean to quantitatively evaluate alternative location configurations for optimum benefit in term of access [16].…”

Section: Discussionmentioning

confidence: 99%

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How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia

et al. 2019

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BackgroundThe accessibility to radiotherapy facilities may affect the willingness to undergo treatment. We sought to quantify the distance and travel time of Malaysian population to the closest radiotherapy centre and to estimate the megavoltage unit (MV)/million population based on the regions.Materials & methodsData for subdistricts in Malaysia and radiotherapy services were extracted from Department of Statistics Malaysia and Directory of Radiotherapy Centres (DIRAC). Data from DIRAC were validated by direct communication with centres. Locations of radiotherapy centres, distance and travel time to the nearest radiotherapy were estimated using web mapping service, Google Map.ResultsThe average distance and travel time from Malaysian population to the closest radiotherapy centre were 82.5km and 83.4mins, respectively. The average distance and travel were not homogenous; East Malaysia (228.1km, 236.1mins), Central (14.4km, 20.1mins), East Coast (124.2km, 108.8mins), Northern (42.9km, 42.8mins) and Southern (36.0km, 39.8mins). The MV/million population for the country is 2.47, East Malaysia (1.76), Central (4.19), East Coast (0.54), Northern (2.40), Southern (2.36). About 25% of the population needs to travel >100 km to get to the closest radiotherapy facility.ConclusionOn average, Malaysians need to travel far and long to reach radiotherapy facilities. The accessibility to radiotherapy facilities is not equitable. The disparity may be reduced by adding centres in East Malaysia and the East Coast.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia

et al. 2019

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“…35 Based on simulation results in finding optimal locations for radiation, studies suggested adding new centers in underserved areas or non-centralized small-city to improve geographic access. 37, 38 …”

Section: Discussionmentioning

confidence: 99%

Association Between Geographic Access to Cancer Care and Receipt of Radiation Therapy for Rectal Cancer

Lin

Bruinooge

Kirkwood

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Purpose Trimodality therapy (chemoradiation and surgery) is standard of care for Stage II/III rectal cancer but nearly one third of patients do not receive radiation therapy (RT). We examined the relationship between density of radiation oncologist and travel distance to receipt of RT. Materials/Methods A retrospective study based on the National Cancer Data Base identified 26,845 patients aged 18–80 with Stage II/III rectal cancer diagnosed between 2007–2010. Radiation oncologists were identified through Physician Compare Dataset. Generalized Estimating Equations clustering by Hospital Service Area was utilized to examine the association between geographic access and receipt of RT, controlling for patient sociodemographic and clinical characteristics. Results 70% of patients received RT within 180 days of diagnosis or within 90 days of surgery. Compared to travel distance <12.5 miles, patients diagnosed at reporting facility who traveled ≥50 miles had a decreased likelihood of receipt of RT (50–249 miles: adjusted Odds Ratio [aOR] 0.75, p<.001; ≥250 miles: aOR 0.46, p=.002), all else being equal. Density level of radiation oncologists was not significantly associated with receipt of RT. Patients who were female, nonwhites, ≥50 years, and with comorbidities were less likely to receive RT (p<.05). Patients who were uninsured but self-paid for their medical services, initially diagnosed elsewhere but treated at reporting facility, and resided in Midwest had increased likelihood of receipt of RT (p<.05). Conclusions Increased travel burden was associated with a decreased likelihood of receiving RT for stage II/III rectal cancer patients when all else being equal, but radiation oncologist density was not. Further research in geographic access and establishing transportation assistance programs, or lodging services for patients with unmet need may help decrease geographic barriers and improve the quality of rectal cancer care.

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“…Between January 1995 and January 2015, the number of cancer centres providing rt in Canada more than doubled, improving geographic access to rt. Building additional rt centres was motivated in part by long wait times for rt, and evidence that rt utilization declined with distance to the cancer centre and improved when access was more convenient 3,6,7,[11][12][13][14][15] . Improving geographic access by building cancer centres is one way to be patientcentred, because more convenient locations respond to a patient preference to access care closer to home.…”

Section: Figurementioning

confidence: 99%

Patient Preferences for Timing and Access to Radiation Therapy

et al. 2015

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Purpose Patient preferences for radiation therapy (rt) access were investigated. MethodsPatients completing a course of rt at 6 centres received a 17-item survey that rated preferences for time of day; day of week; actual, ideal, and reasonable travel times for rt; and actual, ideal, and reasonable times between referral and first oncologic consultation. Patients receiving single-fraction rt or brachytherapy alone were excluded. ResultsOf the respondents who returned surveys (n = 1053), 54% were women, and 74% had received more than 15 rt fractions. With respect to appointment times, 88% agreed or strongly agreed that rt between 08h00 and 16h30 was preferred; 14%-15% preferred 07h30-08h00 or 16h30-17h00; 10% preferred 17h00-18h00; and 6% or fewer preferred times before 07h30 or after 18h00. A preference not to receive rt before 07h30 or after 18h00 was expressed by 30% or more of the respondents. When days of the week were considered, 18% and 11% would have preferred to receive rt on a Saturday or Sunday respectively; 52% and 55% would have preferred not to receive rt on those days. A travel time of 1 hour or less for rt was reported by 82%, but 61% felt that a travel time of 1 hour or more was reasonable. A first consultation within 2 weeks of referral was felt to be ideal or reasonable by 88% and 73% of patients respectively.Conclusions An rt service designed to meet patient preferences would make most capacity available between 08h00 and 16h30 on weekdays and provide 10%-20% of rt capacity on weekends and during 07h30-08h00 and 16h30-18h00 on weekdays. Approximately 80%, but not all, of the responding patients preferred a 2-week or shorter interval between referral and first oncologic consultation.

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Optimal Location of Radiation Therapy Centers With Respect to Geographic Access

Abstract: The proposed framework and model provide a data-driven means to quantitatively evaluate alternative configurations of a regional RT system. Results suggest that the choice of location for future centers can significantly improve geographic access to RT.

Cited by 14 publications

References 14 publications

How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia

How many roads must a Malaysian walk down? Mapping the accessibility of radiotherapy facilities in Malaysia

Association Between Geographic Access to Cancer Care and Receipt of Radiation Therapy for Rectal Cancer

Patient Preferences for Timing and Access to Radiation Therapy

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