Inequalities in access to cancer treatment: an analysis of cross-regional patient mobility in Greece

Athanasakis, Kostas; Souliotis, Kyriakos; Kyriopoulos, Elias-John; Loukidou, Evangelia; Kritikou, P.; Kyriopoulos, John

doi:10.1007/s00520-011-1093-0

Cited by 13 publications

(15 citation statements)

References 28 publications

(27 reference statements)

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“…• Xs are more likely to have a defeatist attitude towards illness • Xs are more likely to experience fear and denial related to cancer • X's attitudes about the body/the treatment might lead to differential treatments • Xs are more likely than Ys to have misperceptions about cancer and treatment benefits • Xs might be more fearful or adverse to specific treatments than Ys • Xs are more likely than Ys to mistrust the healthcare system • Xs might not be able to deal with psychosocial difficulties or endure treatments well • Xs might have differential treatment or care preferences Machens and Dralle [79] Ess et al [36] N i e d e r et al [95] Athanasakis et al [7] Lin et al [75] colleagues [3], for example, report that immigrant women remarked on their lack of control or choice in referral processes. In contrast, advantaged social status and ease in verbal communication positively influenced the likelihood of referrals in a study by Somerset and colleagues [127].…”

Section: Compromised Bodiesmentioning

confidence: 99%

Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Sinding

Warren

Fitzpatrick‐Lewis

et al. 2014

Support Care Cancer

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The paper reviews published studies focused on disparities in receipt of cancer treatments and supportive care services in countries where cancer care is free at the point of access. We map these studies in terms of the equity stratifiers they examined, the countries in which they took place, and the care settings and cancer populations they investigated. Based on this map, we reflect on patterns of scholarly attention to equity and disparity in cancer care. We then consider conceptual challenges and opportunities in the field, including how treatment disparities are defined, how equity stratifiers are defined and conceptualized and how disparities are explained, with special attention to the challenge of psychosocial explanations.

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Section: Compromised Bodiesmentioning

confidence: 99%

Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Sinding

Warren

Fitzpatrick‐Lewis

et al. 2014

Support Care Cancer

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“…Socioeconomic deprivation can therefore be considered a proxy variable for non-spatial access to treatment. Further, while socioeconomic deprivation is a well-established predictor of cancer incidence [19][20][21][22][23][24] , rates of treatment 25 , and survival 24,[26][27][28][29] , there is some evidence that these socioeconomic disparities also reflect poor spatial access to screening, diagnosis, and treatment 6,7,24,[30][31][32][33] .…”

mentioning

confidence: 99%

“…, and survival 24,[26][27][28][29] , there is some evidence that these socioeconomic disparities also reflect poor spatial access to screening, diagnosis, and treatment 6,7,24,[30][31][32][33] . In order to provide more geographically equitable access to treatment in British Columbia (BC), Canada, the British Columbia Cancer Agency has established five new comprehensive cancer treatment centers since 1995, in addition to the original BC Cancer Centre in the city of Vancouver.…”

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confidence: 99%

Socioeconomic disparities in head and neck cancer patients’ access to cancer treatment centers

Walker

Schuurman

Auluck³

et al. 2017

Rural Remote Health

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Introduction: Both socioeconomic status and travel time to cancer treatment have been associated with treatment choice and patient outcomes. An improved understanding of the relationship between these two dimensions of access may enable cancer control experts to better target patients with poor access, particularly in isolated suburban and rural communities. Methods: Using geographical information systems, head and neck cancer patients across British Columbia, Canada from 1981 to 2009, were mapped and their travel times to the nearest treatment center at their time of diagnosis were modelled. Patients' travel times were analysed by urban, suburban, and rural neighborhood types and an index of multiple socioeconomic deprivation was used to assess the role of socioeconomic status in patients' spatial access. Results: Significant associations between socioeconomic deprivation and spatial access to treatment were identified, with the most deprived quintiles of patients experiencing nearly twice the travel time as the least deprived quintile. The sharpest disparities were observed among the most deprived patient populations in suburban and rural areas. However, the establishment of new treatment centers has decreased overall travel times by 28% in recent decades. Conclusions: Residence in a neighborhood with high socioeconomic deprivation is strongly associated with head and neck cancer patients' spatial access to cancer treatment centers. Patients residing in the most socioeconomically deprived neighborhoods consistently have longer travel times in urban, suburban, and rural communities in the study area.Key words: cancer treatment, socioeconomic status, deprivation, head and neck cancers, spatial access, geographic information systems, Canada.© BB Walker, N Schuurman, A Auluck, SA Lear, M Rosin 2017. A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2 IntroductionWith an estimated 525 000 new cases in 2012, head and neck cancers are the eighth most common non-melanoma cancers globally 1. This number is expected to grow significantly in the coming decades, resulting in increased demand for treatment 2 .To maximize efficiency, comprehensive cancer treatment facilities are most commonly located in areas where they service the largest proportion of the patient population, generally in large urban centers. This results in a geographical inequity, such that individuals living farther from a cancer treatment center experience a greater travel burden in order to attend their treatment, particularly those living in rural and remote areas , and survival 14. The time required for patients to travel from the home to a cancer treatment center is therefore an important factor throughout the continuum of care, and may inform more efficient and equitable cancer control programs and policy.The travel time required for an individual to reach a treatment center provides a quantitative measure of access 15 . However, an individual's access to a health service may also be measured as the ...

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“…Finally, the analysis did not show a correlation between the numbers of physicians with public health spending, whereas a marginally significant negative relationship with private expenditure emerged. Although this finding is partially contradicted by the literature, it is likely that it reflects the peculiarities of the Greek health care setting and, especially, the severe discrepancies in the distribution of physicians and health technology, as a whole, throughout the country 24 . Irrespective of which determinant affects the evolution of health care expenditure in Greece across these four decades, it is plain that the role of Primary Care in a health system with these characteristics is highly critical.…”

Section: Figure 5: Interactive Scatterplot -Private Hce Vs Populationmentioning

confidence: 61%

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2014

IJPSR

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This paper identifies and analyzes the determinants of public and private health care expenditure in Greece over the period 1970-2004 to assess its relationship with the lack of an integrated Primary Health Care System. The determinants assessed are those commonly stated in international literature as influencing health expenditure growth, i.e. per capita GDP-Gross Domestic Product-(income), demographic ageing and induced demand, expressed through the number of physicians. Several multiple linear regression models were developed and selected through stepwise entry and backward elimination. Dependent variables were per capita public and private health care expenditure. According to the results, the most important determinant, for both public and private health care expenditure, is population ageing. Per capita GDP is strongly and positively related to public health care expenditure, as well as to private health care expenditure, the latter, however, in a non-statistically significant form. The development of an Integrated Primary Health Care System in Greece has been constantly under discussion and review for the past two decades. Nonetheless, the lack of gatekeeping mechanisms as well as patient monitoring and general population prevention programmes have led to significant and consistent increases in both public and private expenditure. INTRODUCTION: Over the last three decades, the issue of defining the determinants of healthcare spending, public or private has remained quite active across the literature.

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Inequalities in access to cancer treatment: an analysis of cross-regional patient mobility in Greece

Cited by 13 publications

References 28 publications

Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Socioeconomic disparities in head and neck cancer patients’ access to cancer treatment centers

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