TY - JOUR
T1 - Transportation - A vehicle or roadblock to cancer care for VA patients with colorectal cancer?
AU - Zullig, Leah L.
AU - Jackson, George L.
AU - Provenzale, Dawn
AU - Griffin, Joan M.
AU - Phelan, Sean
AU - Van Ryn, Michelle
N1 - Funding Information:
Funding sources: This work was supported by the Inter-agency Quality of Cancer Care Committee, Applied Research Branch, National Cancer Institute through an Interagency Agreement with the Veterans Health Administration ( IAG V246S-00054 ). During part of this work, Dr Jackson held a Merit Review Entry Program award from the Veterans Affairs Health Services Research & Development Service (MRP-05-312). Dr Provenzale was supported by an NIH K24 (DK002926-07) .
PY - 2012
Y1 - 2012
N2 - Patients must have transportation before they can access appropriate cancer care. The Cancer Care Assessment & Responsive Evaluation Studies (C-CARES) questionnaire surveyed colorectal cancer patients diagnosed in 2008 throughout the VA healthcare system. A minority (19%) of respondents reported transportation barriers. Patients experiencing pain and who reported no primary social support (OR 6.13, 95% CI 3.10, 12.14) or non-spousal support (OR 2.00, 95% CI 1.40, 2.87) were more likely to experience transportation barriers. Background: Patients must have transportation to the treatment site before they can access appropriate cancer care. This article describes factors associated with patients experiencing transportation-related barriers to accessing cancer care. Patients and Methods: The Cancer Care Assessment & Responsive Evaluation Studies (C-CARES) questionnaire was mailed to Veterans Affairs (VA) patients with colorectal cancer (CRC) during the fall of 2009. Eligible patients were diagnosed at any VA facility in 2008, they were men, and alive at the time of the mailing. A total of 1409 surveys were returned (approximately 67% response rate). To assess transportation barriers, patients were asked how often it was difficult to get transportation to or from treatment. Symptoms were assessed using validated Patient-Reported Outcomes Measurement Information System (PROMIS) scales for fatigue, pain, and depression. Multivariate logistic regression was used to examine determinants of transportation barriers. Results: A minority of respondents (19%) reported transportation barriers. Patients experiencing pain (OR, 1.04; 95% CI, 1.02-1.06) had greater odds of transportation barriers than patients without this symptom. Patients who reported no primary social support (OR, 6.13; 95% CI, 3.10-12.14) or nonspousal support (OR, 2.00; 95% CI, 1.40-2.87) were more likely to experience transportation barriers than patients whose spouses provided social support. Discussion: Patients with uncontrolled pain or less social support have greater odds of transportation barriers. The directional association between social support, symptoms, and transportation cannot be determined in this data. Conclusion: Inquiring about accessible transportation should become a routine part of cancer care, particularly for patients with known risk factors.
AB - Patients must have transportation before they can access appropriate cancer care. The Cancer Care Assessment & Responsive Evaluation Studies (C-CARES) questionnaire surveyed colorectal cancer patients diagnosed in 2008 throughout the VA healthcare system. A minority (19%) of respondents reported transportation barriers. Patients experiencing pain and who reported no primary social support (OR 6.13, 95% CI 3.10, 12.14) or non-spousal support (OR 2.00, 95% CI 1.40, 2.87) were more likely to experience transportation barriers. Background: Patients must have transportation to the treatment site before they can access appropriate cancer care. This article describes factors associated with patients experiencing transportation-related barriers to accessing cancer care. Patients and Methods: The Cancer Care Assessment & Responsive Evaluation Studies (C-CARES) questionnaire was mailed to Veterans Affairs (VA) patients with colorectal cancer (CRC) during the fall of 2009. Eligible patients were diagnosed at any VA facility in 2008, they were men, and alive at the time of the mailing. A total of 1409 surveys were returned (approximately 67% response rate). To assess transportation barriers, patients were asked how often it was difficult to get transportation to or from treatment. Symptoms were assessed using validated Patient-Reported Outcomes Measurement Information System (PROMIS) scales for fatigue, pain, and depression. Multivariate logistic regression was used to examine determinants of transportation barriers. Results: A minority of respondents (19%) reported transportation barriers. Patients experiencing pain (OR, 1.04; 95% CI, 1.02-1.06) had greater odds of transportation barriers than patients without this symptom. Patients who reported no primary social support (OR, 6.13; 95% CI, 3.10-12.14) or nonspousal support (OR, 2.00; 95% CI, 1.40-2.87) were more likely to experience transportation barriers than patients whose spouses provided social support. Discussion: Patients with uncontrolled pain or less social support have greater odds of transportation barriers. The directional association between social support, symptoms, and transportation cannot be determined in this data. Conclusion: Inquiring about accessible transportation should become a routine part of cancer care, particularly for patients with known risk factors.
KW - Access to health care
KW - Colorectal neoplasms
KW - Health services research
KW - Veterans Affairs
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U2 - 10.1016/j.clcc.2011.05.001
DO - 10.1016/j.clcc.2011.05.001
M3 - Article
C2 - 21803001
AN - SCOPUS:84861543021
SN - 1533-0028
VL - 11
SP - 60
EP - 65
JO - Clinical Colorectal Cancer
JF - Clinical Colorectal Cancer
IS - 1
ER -