Geographic Access to Cancer Treatment in Japan: Results From a Combined Dataset of the Patient Survey and the Survey of Medical Institutions in 2011

Abstract

Background: There has been no nationwide analysis of travel time for hospital admission in Japan. Factors associated with travel time are also unknown. This study aimed to describe the distribution of travel time for hospital admission of cancer patients and identify underlying factors. Methods: The individual data from the Patient Survey in 2011 were linked to those from the Survey of Medical Institutions in the same year, and GIS data were used to calculate driving travel time between the addresses of medical institutions and the population centers of municipalities where patients lived. Proportions of patients with travel time exceeding versus not exceeding 45 minutes were calculated. To analyze the data with consideration of both individual factors of patients and geographical characteristics of areas where patients lived, multilevel logistic model analysis was performed. Results: The analysis included 50,845 cancer inpatients. The majority of the cancer patients (approximately 80%) were admitted to hospitals located less than a 45-minute drive from their residences. The travel time tended to be longer for younger patients. The proportion of patients with travel time ≥45 minutes was lower among those with stomach or colorectal cancer (approximately 15%) than those with cervical cancer or leukemia (approximately 30%). The lack of designated cancer care hospitals in the secondary healthcare service areas was significantly associated with travel time. Conclusions: Selection of hospitals by cancer inpatients is affected by age, cancer sites, and availability of designated cancer care hospitals in the secondary healthcare service areas where patients live.

Keywords

• geographic information systems
• health services accessibility
• healthcare disparities
• neoplasms
• travel time