Abstract
Objective:In 2013, 15 childhood cancer hub hospitals in Japan were designated to provide quality medical treatment and care. The present study assessed hospital accessibility by investigating travel times and distances from patient residences. Methods:A total of 37,309 residence/hospital pairs were generated using the addresses of 15 hub hospitals that were designated in 2019 and local government offices in 2014. Using the Google Directions Application Programming Interface (API), travel times and distances were calculated on the assumption that each patient would arrive by driving to the hospitals by 10 am on Wednesday, November 6, 2019. Thus, after identifying the nearest hospital for each residence and deriving adjusted estimated travel times (AETT), the data were summarized according to the regional block using weighted population descriptive statistics for children under 15 years of age in 2015. The cumulative distribution functions of the weighted mean of AETT were also plotted. Results:Childhood cancer patients could access the nearest hub hospital by traveling approximately 1.78 hours (AETT, range: 0.1 to 41.8) and 91.86 km (range: 1.0 to 1438.0). Moreover, a total of 94.5% of patients had the nearest hub hospital within their own regional block. The cumulative distribution functions of AETT indicated that many children in three blocks with multiple hub hospitals have shorter travel times and better hospital accessibility than those in other blocks. Conclusions:Although feasibility is ultimately dependent on each patient’s condition and situation, child cancer patients on average can likely complete hospital visits from home and return within a single day. However, this is likely not the case for children who live at considerable distances from hub hospitals. We found regional differences in travel times and distances, depending on whether a given block contained multiple hub hospitals.
Highlights
It is rare for cancer to affect children between 0 and 14 years of age
After identifying the nearest hospital for each residence and deriving adjusted estimated travel times (AETT), the data were summarized according to the regional block using weighted population descriptive statistics for children under 15 years of age in 2015
The cumulative distribution functions of AETT indicated that many children in three blocks with multiple hub hospitals have shorter travel times and better hospital accessibility than those in other blocks
Summary
It is rare for cancer to affect children between 0 and 14 years of age. There was concern that many hospitals were treating only a handful of affected children each year. The centralization of cancer hospitals was an important measure for improving survival rates (Knops et al, 2013). Childhood cancer survivors have higher risks of incurring a broad range of health conditions resulting from the long-term negative effects associated with some medical treatments and/or cancer types (Armstrong et al, 2014; Ishida et al, 2016; Furui et al, 2019). The centralization of these treatment hospitals is an important cancer control measure that will eventually ensure quality medical treatment and care
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