Cancer patients with barriers to transportation have an increased risk of emergency department (ED) visits, cancer-specific mortality, and all-cause mortality, a new study suggests.
The study’s findings were presented at the 2022 ASCO Quality Care Symposium by Changchuan Jiang, MD, of Roswell Park Comprehensive Cancer Center in Buffalo, New York.
For this study, Dr Jiang and colleagues evaluated data from 28,640 cancer patients and 470,024 adults without a history of cancer. The researchers used data from the 2000-2018 National Health Interview Survey (NHIS) linked to the NHIS National Death Index Mortality Files.
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The researchers defined transportation barriers as self-reported delays in medical care during the past 12 months due to a lack of transportation.
Overall, 2.8% of cancer patients had transportation barriers, as did 1.7% of adults without a history of cancer. In the cancer cohort, patients with transportation barriers tended to be younger and female, belong to a racial/ethnic minority group, and have a higher comorbidity burden and functional limitations.
Dr Jiang said that transportation barriers were associated with lack of a routine place for care, regardless of whether patients had a cancer history.
Among patients with transportation barriers, those with a cancer history had triple the risk of ED use (odds ratio [OR], 3.09; P <.05), and those without a cancer history had more than double the risk of ED use (OR, 2.26; P <.05).
Transportation barriers were also associated with increased all-cause mortality risk among patients with a history of cancer (hazard ratio [HR], 2.28; P <.001) and among those without a cancer history (HR, 1.57; P <.001).
Cancer-specific mortality was also increased among cancer patients with transportation barriers (HR, 1.30; P <.05).
“We believe that more efforts need to be spent on how to screen, identify, and reduce transportation barriers to optimize care delivery and patient health outcomes,” Dr Jiang said.
He also mentioned several limitations to this study, including a narrow definition of transportation barriers and no detailed information on cancer stage, treatment, or geographic location. In addition, he noted, people with severe health conditions may be less likely to participate in household surveys.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Jiang C, Deng L, Perimbeti S, et al. Associations of delays in care due to transportation barriers and care utilization, and cause-specific mortality risk among the U.S. adults with a cancer history. ASCO Quality Care Symposium 2022. Sept. 30 – Oct. 1, 2022. Abstract 70.
