Travel impacts for patients with cancer living in the rural Mountain West.

Abstract

e13533 Background: Limited oncology clinical care resources in rural and frontier areas affect the quality of cancer care and outcomes. Drive times to a cancer center in the Mountain West can exceed 180 minutes and are severely impacted by harsh winter weather. The lived experiences of patients traveling from rural and frontier areas to access cancer care are largely unknown. This study aimed to understand the lived experience of receiving cancer care while living in remote areas. Methods: This mixed-methods exploratory and descriptive study utilized an online questionnaire and key informant interviews to understand how travel affects access to cancer care. The 13-item questionnaire assessed the impact of travel-related factors on missed or rescheduled infusion services for patients currently receiving infusion anti-neoplastic treatments. Follow-up interviews added depth to the survey results, enhancing our understanding of the travel experiences through remote areas to receive care. The study examined cost, mode of transportation, social support received during travel, and travel conditions (e.g., weather) to contextualize patients’ experiences with the distances they traveled. Results: In total, 186 individuals responded to the questionnaire. Sixty-two respondents (33.3%) reported experiencing financial difficulties related to travel costs. Additionally, 98 respondents (53.6%) had to cancel or reschedule appointments due to transportation issues, weather, or other conflicts and commitments. Welch’s t-test was used to compare the reported barriers faced by patients traveling a one-way distance of less than 60 miles (n = 151; 84%) to those traveling 60 miles or more (n = 29; 16%). Twenty-five individuals completed follow-up interviews. The qualitative interviews revealed unique themes regarding the role of community support, and consequential impact of travel barriers and distance, challenges of care coordination across providers and settings, and significant time burden. Conclusions: The travel journey may negatively affect the timely cancer care of patients residing in the rural and frontier Mountain West. People receiving cancer care in the Mountain West have unique travel barriers specific to the geography and weather of the area. Collective results may inform the development of innovative strategies to support timely, comprehensive, and high-quality cancer care in underserved rural and frontier areas.