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Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain)
The centralization of complex surgical procedures for cancer in Catalonia may have led to geographical and socioeconomic inequities. In this population-based cohort study, we assessed the impacts of these two factors on 5-year survival and quality of care in patients undergoing surgery for rectal ca...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9322195/ https://www.ncbi.nlm.nih.gov/pubmed/35886665 http://dx.doi.org/10.3390/ijerph19148814 |
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author | Manchon-Walsh, Paula Aliste, Luisa Borràs, Josep M. Coll-Ortega, Cristina Casacuberta, Joan Casanovas-Guitart, Cristina Clèries, Montse Cruz, Sergi Guarga, Àlex Mompart, Anna Planella, Antoni Pozuelo, Alfonso Ticó, Isabel Vela, Emili Prades, Joan |
author_facet | Manchon-Walsh, Paula Aliste, Luisa Borràs, Josep M. Coll-Ortega, Cristina Casacuberta, Joan Casanovas-Guitart, Cristina Clèries, Montse Cruz, Sergi Guarga, Àlex Mompart, Anna Planella, Antoni Pozuelo, Alfonso Ticó, Isabel Vela, Emili Prades, Joan |
author_sort | Manchon-Walsh, Paula |
collection | PubMed |
description | The centralization of complex surgical procedures for cancer in Catalonia may have led to geographical and socioeconomic inequities. In this population-based cohort study, we assessed the impacts of these two factors on 5-year survival and quality of care in patients undergoing surgery for rectal cancer (2011–12) and pancreatic cancer (2012–15) in public centers, adjusting for age, comorbidity, and tumor stage. We used data on the geographical distance between the patients’ homes and their reference centers, clinical patient and treatment data, income category, and data from the patients’ district hospitals. A composite ‘textbook outcome’ was created from five subindicators of hospitalization. We included 646 cases of pancreatic cancer (12 centers) and 1416 of rectal cancer (26 centers). Distance had no impact on survival for pancreatic cancer patients and was not related to worse survival in rectal cancer. Compared to patients with medium–high income, the risk of death was higher in low-income patients with pancreatic cancer (hazard ratio (HR) 1.46, 95% confidence interval (CI) 1.15–1.86) and very-low-income patients with rectal cancer (HR 5.14, 95% CI 3.51–7.52). Centralization was not associated with worse health outcomes in geographically dispersed patients, including for survival. However, income level remained a significant determinant of survival. |
format | Online Article Text |
id | pubmed-9322195 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93221952022-07-27 Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain) Manchon-Walsh, Paula Aliste, Luisa Borràs, Josep M. Coll-Ortega, Cristina Casacuberta, Joan Casanovas-Guitart, Cristina Clèries, Montse Cruz, Sergi Guarga, Àlex Mompart, Anna Planella, Antoni Pozuelo, Alfonso Ticó, Isabel Vela, Emili Prades, Joan Int J Environ Res Public Health Article The centralization of complex surgical procedures for cancer in Catalonia may have led to geographical and socioeconomic inequities. In this population-based cohort study, we assessed the impacts of these two factors on 5-year survival and quality of care in patients undergoing surgery for rectal cancer (2011–12) and pancreatic cancer (2012–15) in public centers, adjusting for age, comorbidity, and tumor stage. We used data on the geographical distance between the patients’ homes and their reference centers, clinical patient and treatment data, income category, and data from the patients’ district hospitals. A composite ‘textbook outcome’ was created from five subindicators of hospitalization. We included 646 cases of pancreatic cancer (12 centers) and 1416 of rectal cancer (26 centers). Distance had no impact on survival for pancreatic cancer patients and was not related to worse survival in rectal cancer. Compared to patients with medium–high income, the risk of death was higher in low-income patients with pancreatic cancer (hazard ratio (HR) 1.46, 95% confidence interval (CI) 1.15–1.86) and very-low-income patients with rectal cancer (HR 5.14, 95% CI 3.51–7.52). Centralization was not associated with worse health outcomes in geographically dispersed patients, including for survival. However, income level remained a significant determinant of survival. MDPI 2022-07-20 /pmc/articles/PMC9322195/ /pubmed/35886665 http://dx.doi.org/10.3390/ijerph19148814 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Manchon-Walsh, Paula Aliste, Luisa Borràs, Josep M. Coll-Ortega, Cristina Casacuberta, Joan Casanovas-Guitart, Cristina Clèries, Montse Cruz, Sergi Guarga, Àlex Mompart, Anna Planella, Antoni Pozuelo, Alfonso Ticó, Isabel Vela, Emili Prades, Joan Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain) |
title | Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain) |
title_full | Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain) |
title_fullStr | Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain) |
title_full_unstemmed | Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain) |
title_short | Socioeconomic Status and Distance to Reference Centers for Complex Cancer Diseases: A Source of Health Inequalities? A Population Cohort Study Based on Catalonia (Spain) |
title_sort | socioeconomic status and distance to reference centers for complex cancer diseases: a source of health inequalities? a population cohort study based on catalonia (spain) |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9322195/ https://www.ncbi.nlm.nih.gov/pubmed/35886665 http://dx.doi.org/10.3390/ijerph19148814 |
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