Travel For Treatment Research Articles

Transfers and anesthesia-related postoperative outcomes after 3361 same-day cancer surgeries at a freestanding surgery center: An observational retrospective study.

Expanding outpatient surgery to the increasing number of procedures and patient populations warrants continuous evaluation of postoperative outcomes to ensure the best care and safety. We describe adverse postoperative outcomes and transfer rates related to anesthesia in a large sample of patients who underwent same-day cancer surgery at a freestanding ambulatory surgery center. Between January 2017 and June 2021, 3361 cancer surgeries, including breast and plastic, head and neck, gynecology, and urology, were performed. The surgeries were indicated for diagnosis, staging, and/or treatment. We report the incidence of transfers and adverse postoperative outcomes related to anesthesia. Breast and plastic surgeries were the most common (1771, 53%), followed by urology (1052, 31%), gynecology (410, 12%), and head and neck surgeries (128, 4%). Based on patients'first procedure, comorbidity levels were highest for urology (75% American Society of Anesthesiologists physical status score 3, 1.7% score 4) and lowest for breast surgeries (31% score 3, 0.2% score 4). Most gynecology surgeries used general anesthesia (97.6%), whereas breast surgeries used the least (38%). A total of sevenpatients (0.2%; 95% CI: 0.08%-0.4%) were immediately transferred to an outside hospital; fourdue to anesthesia-related reasons. Only 7 (0.2%) patients needed additional postoperative care related to anesthesia-related adverse events, specifically cardiac events (4), difficult intubations (2), desaturation (1), and agitation, nausea, and headache (1). The incidence of anesthesia-related adverse postoperative outcomes is low in cancer patients undergoing outpatient surgeries at our freestanding ambulatory surgery center. This suggests that carefully selected cancer patients, including patients with metastatic cancer, can undergo anesthesia for same-day surgery, making cancer care accessible locally and reducing stress associated with travel for treatment. More research investigating complication rates related to surgery and to cancer disease trajectory are needed to establish a complete evaluation of safety for outpatient cancer surgery.

Abstract B012: An investigation of travel distances for breast cancer treatment among a racially and socioeconomically diverse cohort

Abstract Background: In South Carolina, black women are less likely to be diagnosed with breast cancer, but yet are more likely to die with their disease. The disparity is estimated to be as great as 60% higher for black women compared to white women after accounting for the lower incidence. Distances that cancer patients travel to receive treatments are likely to influence treatment decisions and ultimately survival; however, this relationship is not well described. Purpose: The purpose of this investigation was to compare average travel distances for each modality of breast cancer treatment including surgery, chemotherapy, radiation therapy, and hormonal therapy. We furthermore examined the impact of these distances on disease-free survival. Methods: SC Central Cancer Registry data (2002-2010) were linked to administrative data from Medicaid or another private payor insurance plan. Eligibility criteria included white or black race and continuous enrollment in their respective insurance plan for 3 years post diagnosis. Network distances from the patient residence to the provider were calculated by Arc GIS. T-tests and chi-square tests were used to compare descriptive statistics as appropriate. Cox proportional hazards models were used to assess the relationship between treatment travel distances and survival. Results: Patients in the cohort traveled an average distance of 20, 21, 19, and 7 miles for surgical, chemotherapy, radiation therapy, and hormone therapy (pharmacy). Travel distances were significantly higher for blacks for chemotherapy (23 vs 20 miles, p=0.03), but not for any other therapy modalities. As might be expected, patients residing in rural areas had significantly higher travel distances for all treatment modalities, including hormonal therapies. In comparison to urban-dwelling patients, rural residents traveled an average of 36 vs 17 miles for surgery (p<0.01), 37 vs. 17 miles for chemotherapy (p<0.01), 34 vs. 16 miles for radiation therapy (p<0.01), and 23 vs 6 miles for hormone therapy (p=0.01). In examining survival, no travel distance was significantly associated with increased morality. Conclusion: Rural residents traveled significantly longer distances to receive their cancer care compared to urban-dwelling residents; however, this did not appear to impact survival in this cohort. Additional work is needed to fully understand the influence of travel distances on treatment decisions that may ultimately impact survival. These findings highlight the need for innovative solutions to improve access to care for rural residents. Citation Format: Sue P. Heiney, Samantha C. Truman, Oluwole Babatunde, Christian R. Alvarado, Swann Arp Adams. An investigation of travel distances for breast cancer treatment among a racially and socioeconomically diverse cohort [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B012.

The experience and challenges of rural persons with cancer and their families

ObjectiveApproximately 30% of the population of Australia live over 180 km from tertiary healthcare facilities. In rural areas there are fewer health resources and greater travelling distances for treatment. Family support for health care or illness prevention can either be strengthened or disrupted in times of need, yet family is a key aspect of the person’s supportive network. This research sought to understand the experiences and challenges for persons with cancer and their families from rural Queensland. DesignA qualitative study used 14 telephone interviews involving eight persons with cancer and six family members to understand their experience when travel for treatment was required. SettingRural Queensland, Australia. ParticipantsPersons with cancer and family who stayed in Cancer Council Queensland Accommodation. ResultsThree themes developed; confronting diagnosis, challenges, and negotiating support. ConclusionsChallenges included travel concerns and lack of services at home; however, family support and appreciating positive aspects were highlighted as part of the experience. This research identified a need for tailored support, which recognises their rurality. Open communication with health professionals helps identify specific needs and service barriers.

TRAVEL TO THE HEALING CENTERS IN THE EGYPTIAN TEMPLES: THE PROTOTYPE OF THE MODERN MEDICAL TOURISM

A travel for treatment was one of the oldest motivations for travel in ancient world. Among thesites that attracted such travelers were the supposed healing centers in Egyptian temples. As theancient Egyptian physicians were very clever in their profession, they had a very remarkablefame not only in Egypt but among the patients of other ancient nations as well. The ancientEgyptian and foreigner patients traveled to those medical centers to spend a night or moreseeking for cure by medical treatment or through dreams and messages from gods. Thearchitectural evidences prove the existence of such healing centers in the temples. The onlypreserved example is the sanatorium within the precinct of the Hathor temple at Dendera, inUpper Egypt. According to the modern concept of tourism, such travels were more or less a typeof tourism. In this context, this paper, through the textual, pictorial, and architectural evidences,tries to originate the earlier examples of medical tourism, as well as it applies the concept andcomponents of present tourism on the travels of ancient Egyptian and foreigner patients.

1583P - Patient reported stressors in the practical domain of a cancer diagnosis: The impact of socioeconomic status and geographic location

Background: Socioeconomic status (SES) and geographic location may influence access to cancer care. In the Canadian health care system, cancer care is publically funded however, other factors including workplace absences and travel for treatment can be additional stressors. We aimed to assess patient reported distress in the practical aspects of accessing cancer treatment in relation to their SES and community size. Methods: BC Cancer provides cancer care to a population of 4.6 million dispersed over 944, 735 km2. All patients referred to BC Cancer from 2011 – 2016 who completed the Psychosocial Screen for Cancer (PSSCAN-R) within 6 months of cancer diagnosis were included in the study. Baseline characteristics were collected from the BC Cancer registry. The Canadian Postal Code Conversion File Plus (PCCF+) was used to link the patients’ postal codes with standard 2011 census geographic areas and neighbourhood income quintiles. Chi squared test was used for comparisons. Results: 48,954 patients completed the PSSCAN-R and 45 164 had PCCF+ data available. Baseline characteristics: median age 66, 55% female, 17% presented with metastatic disease. Tumor distribution: 22% breast, 19% GI, 13% GU, 13% lung and 33% other. Income quintiles were grouped into lowest/mid-lower, middle, mid-higher/highest. Community size: >1.5M 53%, 1.5M – 10K 17%, <10K 30%. Patients in lowest/mid-lower compared to mid-higher/highest income groups reported more distress around finances (19% vs 14.1%), getting to appointments (15.3% vs 9.7%) and accommodations during treatment (5.6% vs 3.8%). Concerns regarding school/work were similar (10.5% vs 10.9%). Patients in rural versus large communities (1.5M+) reported more distress around finances (19% vs 15.1%), getting to appointments (15% vs 11.9%), accommodations during treatment (9.7% vs 2.7%) and less distress around school/work (9.7% vs 11.8%). Conclusions: Lower SES and rural geographic location are associated with higher levels of cancer patient distress in the practical domain, despite a publically funded medical system. Local navigational support services for workplace and income assistance should be developed to alleviate distress for patients in rural areas or with low income. Legal entity responsible for the study: BC Cancer. Funding: BC Cancer Foundation. Disclosure: All authors have declared no conflicts of interest.

Travel for Treatment

Medical tourism is growing and diversifying at a high rate. The medical tourism in India is poised to be next success story after software industry. This term is used to refer to travel activity that involves a medical procedure or activities that promote the wellbeing of the patient. The term medical tourism is the act of travelling to other countries to obtain medical, dental and surgical care. (Connell 2006) All the beneficiaries of this industry are putting their best foot forward by providing quality services at affordable cost in order to lure medical tourists. It goes without saying that only those health care organizations will survive and succeed in gaining competitive advantage over others that incorporates quality improvement process on a continuous basis. The results show that there is significant growth of medical tourism in India, which is growing at the rate 30% in 2015 (Saravana 2015) The standards of medical treatment and hospital facilities provided to patients have significantly improved in India with 21 hospitals in India already accredited by JCI. In this study hospital chosen for the present study is the hospital one amongst the list of JCI accredited hospitals in India. The objective of this study is to identify the medical tourist's satisfaction level &amp; also to identify the grey areas for better services. The results show that they were quite satisfied with the services availed &amp; are recommending it to others due to the significant treatment services.

Seeking patient feedback to inform changes in thyroid cancer services: A Butterfly Thyroid Cancer Trust initiative

Seeking patient feedback to inform changes in thyroid cancer services: A Butterfly Thyroid Cancer Trust initiative

Travel for treatment: students' perspective on medical tourism

AbstractMedical tourism is the act of travelling abroad for health care. The theory of planned behaviour was used to investigate the medical tourism beliefs of 336 undergraduate students in a basic psychology course at a large midwestern American university. Students did not have positive intentions for mere willingness to seek more information about travelling to a developing country to receive medical treatment. An educational intervention is necessary to help promote travel for medical treatment. The intervention may include educating people on the availability of quality health care, highly trained competent doctors and the ability to vacation and see another country. Copyright © 2010 John Wiley &amp; Sons, Ltd.

Travel for treatment.

Proposals for an internal NHS market have been boosted by opinion poll results which reveal significant numbers of people are prepared to travel anywhere in the UK for quicker medical treatment.