Zentralisierung, Spezialisierung und Ambulantisierung der Versorgung von Kopf-Hals-Tumorpatienten

Vahl, Julius Malte; Böhm, Felix; Brand, Matthias; Witzleben, Adrian von; Hoffmann, Thomas; Laban, Simon

doi:10.1055/a-1851-5257

Cited by 1 publication

(4 citation statements)

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“…This centralization results in a high consistency and a high rate of participation in clinical trials further improving patient care. At the same time, patients must endure longer journeys during treatment 20 …”

Section: Discussionmentioning

confidence: 99%

“…It may therefore be considered that living in a rural area is not a risk factor in general, if a stable socioeconomic structure, prevention measures and access to health care is facilitated. Adaptations in the health care system are a balancing act between centralization of health care and sufficient accessibility for everyone 20 . In Germany, aside from spatial differences in rural/urban areas, at least small disparity between East and West Germany persists more than 30 years after reunification.…”

Section: Discussionmentioning

confidence: 99%

“…Adaptations in the health care system are a balancing act between centralization of health care and sufficient accessibility for everyone. 20 In Germany, aside from spatial differences in rural/urban areas, at least small disparity between East and West Germany persists more than 30 years after reunification. Since then, previously published data described shrinking differences in overall survival amounting to 0.4 years for women and 1.5 years for men in 2002 (largely accounting to differences in cardiovascular mortality).…”

Section: Discussionmentioning

confidence: 99%

“…At the same time, patients must endure longer journeys during treatment. 20 There seems to be a high level of international interest in the relationship between treatment in rural or urban areas and survival/quality of life of cancer patients. An analysis including 583 cancer survivors from the Irish National Cancer Database 21 as well as an analysis of 261 American HNCP 22 showed that HNCP in rural areas are more likely to report about decreased quality of life concerning physical and emotional health status.…”

Section: Socioeconomic Status Seems To Affect Survival Of Hncp In Ger...mentioning

confidence: 99%

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Demographics and access to head and neck cancer care in rural areas compared to urban areas in Germany

Vahl,

Nagel,

Grages

et al. 2023

Cancer Medicine

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BackgroundDemographic development in rural and urban areas differs substantially. Demographics and access to specialized head and neck cancer centers may affect head and neck cancer patients' (HNCP) outcomes. Here, we compare epidemiological indicators and outcomes of HNCP in rural and urban Germany.Patients and MethodsIn a retrospective analysis of data from the Center for Cancer Registry Data (ZfKD) between 2002 and 2017, 212,920 HNCP were included. Incidence, demographics, travel distance to specialized centers, and ground values were compared between rural and urban areas with a focus on their association with patient outcomes.ResultsThe mean age of HNCP was significantly higher in urban areas (mean difference = 1.4 years; p < 0.0001), but increased at a comparable rate (p = 0.26) in rural and urban areas during the observation period. Gender imbalance was higher in rural areas (mean ratio of men/women: 4.1 vs. 3.1; p < 0.0001), but showed a comparable trend toward equilibration in both, rural and urban districts (p = 0.46). The portion of HNCP of the entire HNCP population living in urban areas increased from 55.9% in the year 2002 to 76.4% in the year 2017. There was no significant difference or change in the ratio of advanced to low UICC stage during the observation period (p = 0.26). However, travel distances to medical centers were higher in rural areas, especially (p < 0.0001) in East Germany. Median survival of HNCP in rural areas was significantly lower than in urban areas (42 months [SEM = 0.7; CI: 40.5–43.5] vs. 54 months [SEM = 1.2; CI: 51.7–56.3]; p < 0.0001) in East Germany, whereas in West Germany no significant difference was observed (59 months [SEM = 0.8; CI: 57.4–60.6] vs. 60 months [SEM = 0.5; CI: 59.0–61.0]; p = 0.15).ConclusionsPlace of residence contributes to survival outcome of HNCP. Access to specialized care and socioeconomic factors could be improved in East Germany.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Socioeconomic Status Seems To Affect Survival Of Hncp In Ger...mentioning

confidence: 99%

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