Abstract
Because it is closely linked to socioeconomic factors, spatial accessibility to health care may greatly influence the delivery of optimal care. Owing to the centralisation of care in most countries, travel time to receive optimal care is a growing problem for public health decision-makers and patients.
Although cancer is a serious illness where aggressive treatment is required for a favourable prognosis, there is sound evidence that the problem of distance decay is also relevant to cancer care. While the hypothesis of the decreasing use of healthcare facilities is widely accepted, the consequence of this loss of opportunity is less debated.
Given the influence of isolation on health outcomes, one of the main challenges is to measure accessibility. Unfortunately, most studies have been conducted using a unique measure of accessibility and the reason for choosing a specific indicator instead of another is rarely mentioned.
Owing to either a lower access to specialised facilities or an advanced stage at diagnosis for more isolated patients, most studies have reported that remote patients have a worse survival than their less isolated counterparts.
Even if international comparisons are difficult due to differences in healthcare systems and in country size, the magnitude of geographical inequality in survival across the European Union seems to be relatively modest compared to the deprivation gap in survival. The effect of increased travel times on quality of life and medical expenditure has received little attention in Europe, even though it represents a growing problem for patients.
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Dejardin, O. (2021). Geographical Remoteness and Cancer Survival in Europe. In: Launoy, G., Zadnik, V., Coleman, M.P. (eds) Social Environment and Cancer in Europe. Springer, Cham. https://doi.org/10.1007/978-3-030-69329-9_19
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