Later cancer treatment initiation and fewer treatment options once treatment starts are just some of the impacts of longer driving distances to treatment, according to researchers reporting in a study presented at the 66th Annual Meeting & Exposition held in San Diego, CA.1
Researchers from VA Boston Healthcare System and others evaluated the electronic health records of treatment-naïve multiple myeloma (MM) patients across 3 diverse healthcare settings: the Veterans Affairs (VA) system (1999-2022), MedStar Health (2004-2023), and Boston Medical Center (2007-2023).
The researchers noted that these systems were selected because of their ability to provide care regardless of a patient’s financial means. The team collected demographic data, including distance from home to the hospital, area deprivation index, and income levels (for VA patients only), along with MM disease characteristics such as international staging systemstage and cytogenetics.
The researchers noted variations in time to treatment initiation and choice of therapy across the 3 healthcare settings, with factors such as distance from the hospital and income levels playing significant roles in delays of treatment. At the VA, “patients living a further distance from the nearest VA hospital were significantly less likely to receive treatment within 14 days (<25 kilometers vs >100 kilometers; odds ratio [OR] 0.72, 0.52-0.99) while patients having a higher income level were significantly more likely to receive triplet/quadruplet therapy or an autologous stem cell transplant (>$100k vs <25k per year; [OR] 1.7, 1.3-2.23),” the researchers wrote. At Boston Medical and MedStar, patients who did not have insurance were “significantly less likely to receive triplet/quadruplet therapy or an autologous stem cell transplant ([OR] 0.23, 0.06-0.79 and 0.12, 0.01-0.8, respectively).”
“Living a further distance from the hospital may be associated with later treatment initiation while lack of insurance and a lower income level may limit access to novel therapies or autologous stem cell transplant. This informs next steps to develop a prediction algorithm incorporating these social determinants of health factors that identifies patients at risk for suboptimal treatment,” the researchers concluded in their abstract.
Reference
- Bodanapu G, Corrigan J, Culnan J, et al. Risk factors for suboptimal treatment in patients with newly diagnosed multiple myeloma across US healthcare systems. Presented at: 66th ASH Annual Meeting & Exposition. December 7-10, 2024. San Diego, CA. Abstract 3341.