Cancer care can vary significantly from hospital to hospital, especially for patients considering clinical trials. The quest for the best care for a specific cancer diagnosis could even involve traveling across state lines. While the frequency of these practices has never been evaluated, understanding it could have a profound impact on telehealth guidelines, making it an urgent issue to address.
A team of researchers from Moffitt Cancer Center set out to quantify the extent of cross-state cancer care. Their recent publication in JAMA Network Open presents the results of their study, which identified patients aged 66 or older using Medicare claims. The researchers gathered data from patients diagnosed with breast, colon, lung, or pancreatic cancer between 2017 and 2020, noting if the patient received cancer care outside of his or her state of residence.
The researchers identified over 1 million patients for the study, with an average age of 76.5 years. The study population skewed female (68.2%) and White (85.5%). Most (78.5%) of the participants lived in an urban setting.
The study revealed that about 7% of cancer care occurred across state lines. Of the types of services evaluated (surgery, radiation, and chemotherapy), surgical procedures (8.3%) most often occurred outside of the patient’s home state. Radiation (6.7%) and chemotherapy (5.6%) services less frequently crossed state lines.
The researchers also investigated how far patients traveled for cancer care. This analysis revealed that almost 70% of cross-state cancer care occurred in a state adjacent to the patient’s state of residence.
Patients in rural areas sought cross-state care more frequently than those in urban settings. Rural-residing patients crossed state lines for chemotherapy, radiation, and cancer-related surgery four times, three times, and two and a half times more often than urban-residing counterparts.
The authors conclude that a significant portion of patients using Medicare seek cancer care in a state other than the one in which they reside. This finding, coupled with the higher rate of cross-state treatment for rural patients, underscores the need for accessible telehealth programs. Optimizing telehealth options could help bridge the geographical gap, enabling patients to access oncology services from healthcare providers in other regions.
Sources: JAMA Netw Open
