Are patients willing to travel for better ovarian cancer care?
Are patients willing to travel for better ovarian cancer care?
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DOI：
10.1016/j.ygyno.2017.10.018
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发表时间：
2018-01-01
影响因子：
4.7
通讯作者：
Schapira, Marilyn M.
中科院分区：
文献类型：
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作者：
Shalowitz, David I.;Nivasch, Esther;Schapira, Marilyn M.
目标。在高容量机构治疗的患者实现了改善的结果，这导致了卵巢癌护理集中的呼吁。然而，集中化是否尊重患者对治疗地点的偏好尚不清楚。本研究的目的是确定患者如何平衡生存利益与前往遥远的治疗中心的负担。接受附件肿块评估的患者完成了两项离散选择实验（dce），评估1)额外旅行50英里所需的5年生存益处，以及2)额外旅行距离患者将获得6%的5年生存益处。人口统计数据是通过健康计算、社会支持和旅行舒适度来收集的。采用t检验来检验组间均值的显著差异。81%（50/62）的参与者要求旅行50英里的5年生存率为6%。80%（44/55）的参与者愿意旅行50英里，以获得6%的5年生存效益（DCE#2）。在DCE#2中，没有发现旅行意愿与收集的社会人口学协变量之间的关联。五分之一的卵巢癌患者可能不愿意去转诊中心，即使他们知道这样做对生存有好处。决策者在设计转诊结构时应考虑患者的出行偏好。(C)2017爱思唯尔公司版权所有。
Objective. Improved outcomes realized by patients treated at high-volume institutions have led to a call for centralization of ovarian cancer care. However, it is unknown whether centralization respects patients' preferences regarding treatment location. This study's objective was to determine how patients balance survival benefit against the burdens of travel to a distant treatment center.Methods. Patients presenting for evaluation of adnexal masses completed two discrete choice experiments (DCEs) assessing 1) the 5-year survival benefit required to justify 50 miles of additional travel, and 2) the additional distance patients would travel for a 6% 5-year survival benefit. Demographic data were collected with measures of health numeracy, social support, and comfort with travel. t-Tests were performed to test for significant differences between group means.Results. 81% (50/62) of participants required a 5-year survival benefit of 6% benefit to travel 50 miles. 80% (44/55) of participants would travel >= 50 miles for a set 5-year survival benefit of 6% (DCE#2). No association was identified in DCE#2 between willingness to travel and collected sociodemographic covariates.Conclusions. 1 in 5 patients with ovarian cancer may prefer not to travel to a referral center, even when aware of the survival benefits of doing so. Policymakers should consider patients' travel preferences in designing referral structures for care. (C)2017 Elsevier Inc. All rights reserved.