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Centralisation of cancer surgery and the impact on patients’ travel burden

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  • Versteeg, S.E.
  • Ho, V.K.Y.
  • Siesling, S.
  • Varkevisser, M.

Abstract

Recent years have seen increasing trends towards centralisation of complex medical procedures, including cancer surgery. The impact of these trends on patients’ travel burden is often ignored. This study charts the effects of different scenarios of centralising surgery on the travel burden for patients with cancer of the digestive tract, particularly among vulnerable patient groups. Our analyses include all surgically treated Dutch patients with colorectal, stomach or oesophageal cancer diagnosed in 2012–2013. After determining each patient’s actual travel burden, simulations explored the impact of continued centralisation of cancer surgery under four hypothetical scenarios. Compared to patients’ actual travelling, simulated travel distances under relatively ‘conservative’ scenarios did not necessarily increase, most likely due to current hospital bypassing. Using multivariable regression analyses, as a first exercise, it is examined whether the potential effects on travel burden differ across patient groups. For some cancer types, under more extreme scenarios increases in travel distances are significantly higher for older patients and those with a low SES. Given the potential impact on vulnerable patients’ travel burden, our analysis suggests a thorough consideration of non-clinical effects of centralisation in health policy.

Suggested Citation

  • Versteeg, S.E. & Ho, V.K.Y. & Siesling, S. & Varkevisser, M., 2018. "Centralisation of cancer surgery and the impact on patients’ travel burden," Health Policy, Elsevier, vol. 122(9), pages 1028-1034.
    • Handle: RePEc:eee:hepoli:v:122:y:2018:i:9:p:1028-1034
    DOI: 10.1016/j.healthpol.2018.07.002
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    References listed on IDEAS

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    1. Mesman, Roos & Faber, Marjan J. & Berden, Bart J.J.M. & Westert, Gert P., 2017. "Evaluation of minimum volume standards for surgery in the Netherlands (2003–2017): A successful policy?," Health Policy, Elsevier, vol. 121(12), pages 1263-1273.
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    4. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    5. Mesman, Roos & Westert, Gert P. & Berden, Bart J.M.M. & Faber, Marjan J., 2015. "Why do high-volume hospitals achieve better outcomes? A systematic review about intermediate factors in volume–outcome relationships," Health Policy, Elsevier, vol. 119(8), pages 1055-1067.
    6. Marco Varkevisser & Stéphanie Geest, 2007. "Why do patients bypass the nearest hospital? An empirical analysis for orthopaedic care and neurosurgery in the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(3), pages 287-295, September.
    7. Ho, Vivian & Town, Robert J. & Heslin, Martin J., 2007. "Regionalization versus competition in complex cancer surgery," Health Economics, Policy and Law, Cambridge University Press, vol. 2(1), pages 51-71, January.
    8. Kobayashi, Daisuke & Otsubo, Tetsuya & Imanaka, Yuichi, 2015. "The effect of centralization of health care services on travel time and its equality," Health Policy, Elsevier, vol. 119(3), pages 298-306.
    9. Schut, Frederik T. & Varkevisser, Marco, 2017. "Competition policy for health care provision in the Netherlands," Health Policy, Elsevier, vol. 121(2), pages 126-133.
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    Cited by:

    1. Mensen, Anne, 2022. "Concentration of hospital capacities and patients' access to care," Ruhr Economic Papers 952, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    2. Paula Manchon-Walsh & Luisa Aliste & Josep M. Borràs & Cristina Coll-Ortega & Joan Casacuberta & Cristina Casanovas-Guitart & Montse Clèries & Sergi Cruz & Àlex Guarga & Anna Mompart & Antoni Planella, 2022. "Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain)," IJERPH, MDPI, vol. 19(14), pages 1-15, July.
    3. Elisabetta Listorti & Arianna Alfieri & Erica Pastore, 2022. "Hospital volume allocation: integrating decision maker and patient perspectives," Health Care Management Science, Springer, vol. 25(2), pages 237-252, June.

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