Geographic Access to CT for Lung Cancer Screening: A Census Tract-Level Analysis of Cigarette Smoking in the United States and Driving Distance to a CT Facility
Geographic Access to CT for Lung Cancer Screening: A Census Tract-Level Analysis of Cigarette Smoking in the United States and Driving Distance to a CT Facility
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DOI：
10.1016/j.jacr.2018.07.007
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发表时间：
2019-01-01
影响因子：
4.5
通讯作者：
Rubin, Geoffrey D.
中科院分区：
文献类型：
--
作者：
Tailor, Tina D.;Choudhury, Kingshuk R.;Rubin, Geoffrey D.
目的：卫生保健资源的空间可及性是利用的必要条件。我们的目的是确定，在一个人口普查区的水平，美国吸烟者的地理分布和他们的驾驶距离ACR认证的CT facility.Methods：吸烟者的数量，每个美国人口普查区确定从美国人口普查局的数据（美国社区调查，2011-2015）和人口普查区吸烟患病率估计。驾驶距离，从每个人口普查区的质心到最近的CT设施，确定使用地理信息系统。距离变化进行了评估，并与道人口密度的关系进行了检查与回归models.Results：大多数美国吸烟者（81.8%）在15英里内的CT设施，但是，有相当大的州际和州内变异。对于包含>= 500名吸烟者的人口普查区域，到CT的中位距离为4.3英里。在州一级，中位距离从1.4英里（华盛顿）到29.1英里（怀俄明州）不等。在每个州内，这种变化更大，华盛顿，DC表现出最低的范围（范围，4.3; 0.2-4.5英里）和缅因州表现出最高的范围（范围，244.8; 0.2-245.0英里）。CT设施的距离呈负相关与人口普查区populationdensity.Conclusions：地理变异CT设施访问肺癌筛查（LCS）的实施有影响。人口稠密地区的个人比人口稀少地区的个人有相对更大的空间访问CT设施。需要进一步开展工作，以确定获得LCS的差距，以优化所有合格人群的LCS。
Purpose: Spatial access to health care resources is a requisite for utilization. Our purpose was to determine, at a census tract level, the geographic distribution of US smokers and their driving distance to an ACR-accredited CT facility.Methods: The number of smokers per US census tract was determined from US Census Bureau data (American Community Survey, 2011-2015) and census tract smoking prevalence estimates. Driving distance, from the centroid of each census tract to the nearest CT facility, was determined using a geographic information system. Distance variations were assessed, and relationships with tract population density were examined with regression models.Results: Most US smokers (81.8%) were within 15 miles of a CT facility; however, there was considerable inter- and intrastate variability. For census tracts containing >= 500 smokers, median distance to a CT was 4.3 miles. At the state level, median distance ranged from 1.4 (Washington DC) to 29.1 miles (Wyoming). Within each state, this variation was higher, with Washington, DC, exhibiting the lowest range (range, 4.3; 0.2-4.5 miles) and Maine exhibiting the highest range (range, 244.8; 0.2-245.0 miles). Distance to a CT facility was inversely associated with census tract population density.Conclusions: Geographic variability in CT facility access has implications for lung cancer screening (LCS) implementation. Individuals in densely populated areas have relatively greater spatial access to CT facilities than those in sparsely populated tracts. Further work is needed to identify access disparities to LCS to optimize LCS for all eligible populations.