PURPOSE: Geographic access to care may be associated with receipt of chemotherapy but has not been fully examined. This study sought to evaluate the association between density of oncologists and travel distance and receipt of adjuvant chemotherapy for @entity694 within 90 days of colectomy. @entity1 AND METHODS: @entity1 in the National @entity5 Data Base with @entity5 , diagnosed between 2007 and 2010, and age 18 to 80 years were selected. Generalized estimating equation clustering by hospital service area was conducted to examine the association between geographic access and receipt of oncology services, controlling for @entity1 sociodemographic and clinical characteristics. RESULTS: Of 34,694 @entity1 in the study cohort, 75.7% received adjuvant chemotherapy within 90 days of colectomy. Compared with travel distance less than 12.5 miles, @entity1 who traveled 50 to 249 miles (odds ratio [OR], 0.87; P=.009) or >= 250 miles (OR, 0.36; P<.001) had decreased likelihood of receiving adjuvant chemotherapy. Density level of oncologists was not statistically associated with receipt of adjuvant chemotherapy (low v high density: OR, 0.98; P=.77). When stratifying analyses by insurance status, non-privately insured @entity1 who resided in areas with low density of oncologists were less likely to receive adjuvant chemotherapy (OR, 0.85; P=.03). CONCLUSION: Increased travel burden was associated with a decreased likelihood of receiving adjuvant chemotherapy, regardless of insurance status. @entity1 with nonprivate insurance who resided in low-density oncologist areas were less likely to receive adjuvant chemotherapy. If these findings are validated prospectively, interventions to decrease geographic barriers may improve the timeliness and quality of @entity694 treatment.

Association Between Geographic Access to XXXX Care, Insurance, and Receipt of Chemotherapy: Geographic Distribution of Oncologists and Travel Distance.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity694 :: ('MESH:D003110', 'Disease') :: ['colon cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['stage III colon cancer', 'Cancer']
@entity5 :: (MESH:D009369,Disease) :: ['Cancer']
