Travel burden associated with granulocyte colony-stimulating factor administration in a Medicare aged population: a geospatial analysis.

摘要: OBJECTIVE Prophylaxis with granulocyte colony-stimulating factors (G-CSFs) is recommended for patients receiving myelosuppressive chemotherapy regimens a high risk of febrile neutropenia (FN). G-CSFs should be administered starting the day after chemotherapy, necessitating return trips to oncology clinic at end each cycle. We examined travel burden related prophylactic G-CSF injections in US. METHODS used 2012-2014 Medicare claims data identify national cohort beneficiaries age 65+ non-myeloid cancers who received both and G-CSFs. Patient origin was based on residence ZIP code. Oncologist practice locations hospital addresses were obtained from Physician Compare Hospital websites geocoded using Google Maps Application Programming Interface (API). Driving distance time care site patient code tabulation area (ZCTA) calculated Open Street road networks. Geographic socio-economic characteristics ZCTA US Census Bureau's American Community Survey stratify analyze estimates. RESULTS The mean one-way driving provider 23.8 (SD 30.1) miles 33.3 37.8) minutes. When stratified by population density, varied 12.1 10.1) minutes Very Dense Urban areas 76.7 72.1) Super Rural areas. About 48% had times <20 minutes, but 19% traveled ≥50 minutes one way prophylaxis. Patients above average concentrations aged, poor or disabled residents more likely experience longer travel. CONCLUSIONS Administration therapy can present significant cancer patients. Technological improvements form methods drug delivery might significantly reduce this burden.