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Transportation Barriers Increase Risk of ER Visits and Death in Cancer Patients

According to a new study, cancer patients facing transportation barriers have an increased risk of emergency room visits, cancer-specific mortality and all-cause mortality.

The study findings were presented at ASCO’s 2022 Quality Care Symposium by Changchuan Jiang, MD, of Roswell Park Comprehensive Cancer Center in Buffalo, New York.

For this study, Dr. Jiang and his colleagues evaluated data from 28,640 cancer patients and 470,024 adults with no history of cancer. The researchers used National Health Survey (NHIS) data from 2000-2018 linked to the NHIS National Mortality Index Mortality Files.


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The researchers defined transportation barriers as self-reported delays in medical care in 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 with no 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 higher comorbidity burden and functional limitations.

Dr Jiang said transport barriers were associated with the lack of a place for routine care, whether or not patients had a history of cancer.

Among patients with transportation barriers, those with a history of cancer were three times more likely to use emergency departments (odds ratio [OR]3.09; P P <.05>

Transportation barriers were also associated with an increased risk of all-cause mortality in patients with a history of cancer (relative risk [HR]2.28; P P <.001>

Cancer-specific mortality was also increased in cancer patients with transport barriers (HR, 1.30; P <.05>

“We believe that more effort needs to be put into how to screen, identify and reduce barriers to transport in order to optimize care delivery and patient health outcomes,” said Dr. Jiang. .

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. Also, he noted, people with serious health conditions may be less likely to participate in household surveys.

Disclosures: Some study authors have disclosed affiliations with biotechnology, 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 barriers to transportation and care utilization, and cause-specific mortality risk in US adults with a history of cancer. ASCO Quality Care Symposium 2022. September 30 – October 1, 2022. Abstract 70.