Travel time and access to healthcare for teenagers and young adults with cancer


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Rebecca Birch1, Richard Feltbower1, Eva Morris2,3, Robert West4, Dan Stark5, Ian Lewis6, Sue Morgan5
1Paediatric Epidemiology Group, University of Leeds, Leeds, UK, 2Cancer Epidemiology Group, University of Leeds, Leeds, UK, 3Northern and Yorkshire Cancer Registry and Information Service, Leeds, UK, 4Leeds Institute of Health Sciences, Leeds, UK, 5Institute of Oncology, St James’s University Hospital, Leeds, UK, 6Alder Hey Children’s Hospital, Liverpool, UK

Background

In teenage and young adult cancer care little is known about the relationship between the distance from a patients home address to hospital and a patients decision about where to be treated.

This work aimed to establish how far TYA patients were travelling to healthcare facilities and whether they were travelling beyond the nearest hospital capable of treating them.

Method

14,413 unique combinations of postcode of residence at admission and hospital postcode were identified in the Hospital Episodes Statistics (HES) data. Geographical mapping software was used to calculate road travel time and road travel distance for patients. Euclidean distances were calculated to determine the closest capable hospital for each home address.

Results

The median distance travelled by road was 12.5km and the median travel time was 20 minutes. There were a wide range of travel times and distances for the patients with the greatest distance being 783km.

Patients diagnosed with bone tumours had the greatest median travel distance (25.5km) and travel time (35.4 minutes). Leukaemia patients also travelled further than their peers with the third highest median travel distance (19.8km) the second highest travel median travel time (27.5 minutes). In contrast carcinoma patients travelled the shortest distance (median =11.8km).

Over half of patients (58%) attended their nearest hospital, 42% of patients had admissions to hospitals other than at their nearest trust. Leukaemia, bone tumours and soft tissue sarcoma patients had over half of their admissions to hospitals outside their nearest NHS trust (50%, 56% and 55% respectively).

Conclusion

There is clear variation in travel times and distances for TYA patients, seemingly related to diagnosis. Future work will involve determining whether patients are travelling beyond their local hospital to a cancer centre or TCT unit and also whether there is a relationship between travel time/distance and the treatment received.