The Effect of Distance on the Postoperative Follow-Up of Patients with Breast Carcinoma

Disparity in Preoperative Patient Factors Between Insurance Types in Total Joint Arthroplasty

“…Multiple studies have correlated increased travel distance with poor patient outcomes, and travel distance has been widely used as a surrogate for access to care. [20][21][22][23][24][25][26][27][28][29] In the current study, patients with Iowa Care traveled an average of 29 to 30 miles farther for access to care than patients with private insurance or Medicare. A trend also existed toward patients with Medicaid traveling an average of 24 to 25 miles farther, but this did not reach statistical significance.…”

“…The long travel distances in these groups cannot be correlated with postoperative outcomes data, but it is likely that the longer distances affected patients' abilities to obtain follow-up care. [27][28][29]36 Patients with Iowa Care and Medicaid had with significantly lower SF-36 and WOMAC scores across every tested category. It is possible that the lower survey scores observed in the Iowa Care and Medicaid groups are primarily due to differences in patient medical comorbidities or social factors rather than due to differences in insurance payer.…”

“…Longer travel distances have been correlated with poor outcomes in multiple medical specialties, including increased risk of mortality in prostate cancer, 21 following kidney transplant 22 and myocardial infarction, 23 suboptimal therapy for bladder cancer, 24 poor glycemic control in patients with diabetes mellitus, 25 perinatal mortality, 26 and reduced patient compliance with prescribed treatment plans. [27][28][29] However, few studies have reported the effect of insurance payer type on access to care issues in TJA. [18][19][20] Lastly, improvement in function is the primary goal of TJA.…”