Analyzing hospital choices of colon cancer patients in four states in appalachia

Nina I. Verevkina, Pamela Farley Short, Tse Chuan Yang, Stephen A. Matthews, Fabian Camacho, Roger Anderson

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

While geographic disparities in cancer treatment are documented, little research has investigated patients’ willingness to travel longer distances for treatment at higherquality hospitals. Even fewer studies have compared metropolitan and non-metropolitan patients on this dimension. Using population-based data from the Appalachian counties of four states, we identified all hospitals within a plausible driving distance of each newly diagnosed colon cancer patient and estimated conditional logit models of hospital choices for cancer surgery. Two sets of important findings emerged. First, both metropolitan and non-metropolitan patients chose higher-quality over lower-quality hospitals, and were willing to travel farther to use high-quality facilities. Second, non-metropolitan patients were not willing to travel farther than their metropolitan counterparts to hospitals that were more desirable along most dimensions, but non-metropolitan patients were willing to travel farther to high-volume hospitals. These findings show how travel distances to high-quality hospitals contribute to geographic disparities in colon cancer treatment.

Original languageEnglish (US)
Pages (from-to)587-608
Number of pages22
JournalJournal of Health Care for the Poor and Underserved
Volume30
Issue number2
DOIs
StatePublished - May 2019
Externally publishedYes

Keywords

  • Appalachia
  • Colon cancer
  • Disparities
  • Hospital choice
  • Medicare

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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