Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jan;28(1):54-62.
doi: 10.1111/j.1748-0361.2011.00371.x. Epub 2011 Mar 31.

Is distance to provider a barrier to care for medicaid patients with breast, colorectal, or lung cancer?

John F Scoggins  1 , Catherine R Fedorenko, Sara M A Donahue, Dedra Buchwald, David K Blough, Scott D Ramsey
Affiliations

Is distance to provider a barrier to care for medicaid patients with breast, colorectal, or lung cancer?

John F Scoggins et al. J Rural Health. 2012 Jan.

Abstract

Purpose: Distance to provider might be an important barrier to timely diagnosis and treatment for cancer patients who qualify for Medicaid coverage. Whether driving time or driving distance is a better indicator of travel burden is also of interest.

Methods: Driving distances and times from patient residence to primary care provider were calculated for 3,917 breast, colorectal (CRC) and lung cancer Medicaid patients in Washington State from 1997 to 2003 using MapQuest.com. We fitted regression models of stage at diagnosis and time-to-treatment (number of days between diagnosis and surgery) to test the hypothesis that travel burden is associated with timely diagnosis and treatment of cancer.

Findings: Later stage at diagnosis for breast cancer Medicaid patients is associated with travel burden (OR = 1.488 per 100 driving miles, P= .037 and OR = 1.270 per driving hour, P= .016). Time-to-treatment after diagnosis of CRC is also associated with travel burden (14.57 days per 100 driving miles, P= .002 and 5.86 days per driving hour, P= .018).

Conclusions: Although travel burden is associated with timely diagnosis and treatment for some types of cancer, we did not find evidence that driving time was, in general, better at predicting timeliness of cancer diagnosis and treatment than driving distance. More intensive efforts at early detection of breast cancer and early treatment of CRC for Medicaid patients who live in remote areas may be needed.

PubMed Disclaimer

References

    1. Casey MM, Thiede Call K, Klingner JM. Are rural residents less likely to obtain recommended preventive healthcare services? Am J Prev Med. 2001 Oct;21(3):182–188. - PubMed
    1. Guidry JJ, Aday LA, Zhang D, Winn RJ. Transportation as a barrier to cancer treatment. Cancer Pract. 1997 Nov–Dec;5(6):361–366. - PubMed
    1. Wingo PA, King J, Swan J, et al. Breast cancer incidence among American Indian and Alaska Native women: US, 1999–2004. Cancer. 2008 Sep 1;113(5 Suppl):1191–1202. - PubMed
    1. Perdue DG, Perkins C, Jackson-Thompson J, et al. Regional differences in colorectal cancer incidence, stage, and subsite among American Indians and Alaska Natives, 1999–2004. Cancer. 2008 Sep 1;113(5 Suppl):1179–1190. - PubMed
    1. Henderson JA, Espey DK, Jim MA, German RR, Shaw KM, Hoffman RM. Prostate cancer incidence among American Indian and Alaska Native men, US, 1999–2004. Cancer. 2008 Sep 1;113(5 Suppl):1203–1212. - PubMed

Publication types