Rural areas in the U.S. have significantly less access to telehealth and cancer care services

In a recent study published in the journal PLoS One, researchers analyze telehealth provisions and oncological services available in hospitals throughout the United States before the onset of the coronavirus disease 2019 (COVID-19) pandemic, in addition to examining the sociodemographic and geographic correlates of telehealth access.

Study: Pre-pandemic geographic access to hospital-based telehealth for cancer care in the United States. Image Credit: JPC-PROD / Shutterstock.com

Study: Pre-pandemic geographic access to hospital-based telehealth for cancer care in the United States. Image Credit: JPC-PROD / Shutterstock.com

Background

Geography plays a major role in determining access to high-quality care and treatment for cancer patients, with the outcomes of cancer patients in rural areas in the U.S. worse across all phases as compared to those residing in non-rural areas.

Several studies have identified correlations between geographic barriers and reduced access to high-quality oncologic care for patients with lung, colon, breast, esophagogastric, rectal, and gynecologic cancers. A mismatched distribution of oncologists and cancer care professionals with respect to patient populations, along with the concentration of complex cancer care facilities in high-volume centers, has been attributed to discrepancies in oncological treatment availability.

Telehealth plays a prominent role in alleviating this discrepancy by providing cancer patients in rural areas with outreach facilities. These services also allow oncologists in rural areas to connect with cancer specialists in other regions for consultations.

While telehealth facilities expanded significantly during the COVID-19 pandemic, little is known about the involvement of telehealth in cancer care.

About the study

In the present study, the researchers conducted a retrospective cross-sectional analysis of data from the 2019 Annual Hospital Survey and Information Technology Supplement by the American Hospital Association (AHA), the U.S. Department of Agriculture's Urban Influence Codes (UIC) from 2013, and the Area Health Resources Files for 2018 from the Health Services and Resources Administration (HRSA).

Depending on the availability of telehealth and oncology care in hospitals within their boundaries, counties were categorized based on low, moderate, or high access. Furthermore, a geospatial information mapping system was used to map access to cancer-care-related hospital-based telehealth. Statistical analyses were used to determine correlations between sociodemographic factors and access to oncology care and telehealth at the hospital and county levels.

For the identification of geographic regions with county-level accessibility to telehealth and oncology care, hospital-level telehealth and oncology services were aggregated, with counties classified into three groups.

Low-access counties had no hospitals within the boundaries that provided oncology care or telehealth facilities. Moderate-access counties included those with hospitals that had either telehealth or oncology care, but not both, while high-access counties had hospitals providing both oncology care and telehealth services.

The sociodemographic factors against which access to telehealth and cancer care was analyzed included age, sex, race and ethnicity, English proficiency, broadband access, and health insurance.

Inequitable access to oncology care and telehealth

About 45% of the 4,540 hospitals included in the study were categorized into the high-access group, thus signifying that they had oncological care facilities and offered telehealth services. The moderate-access group, which provided either telehealth or oncological care services, constituted 6% of the examined hospitals, while 18.6% of hospitals offered neither telehealth facilities nor cancer care.

Out of the 3,152 counties examined in this study, 1,288 distributed over 41 U.S. states had no access to telehealth services or cancer care facilities in the hospitals. These counties have a total population of 26.6 million.

In low-access counties, the mean population for each primary care physician was 3,447, which is much higher than that in the moderate-access and high-access counties which had a mean population of 2,714 and 1,706 per primary care physician, respectively. Furthermore, the likelihood of oncology care facilities being present was higher in larger accredited hospitals, as well as hospitals with a higher ratio of Medicaid and Medicare inpatient days.

Alaska Native and American Indian populations had a lower availability of high-quality cancer care and telehealth services. Unsurprisingly, cancer mortality rates also had the highest rural-urban disparity among these two ethnic populations. The distribution of American Indian and Alaska Native populations across the low, moderate, and high access group counties were 10.6%, 6%, and 3.8%, respectively.

Conclusions

The study findings emphasize the need to advocate for rural hospitals to connect through telehealth services with referral centers to improve subspecialty consultation benefits without the need to travel long distances. Furthermore, health equity advocates at state and federal levels must enable mechanisms to improve local care facilities for residents in low-access counties and provide access to facilities in adjacent counties.

Telehealth facilities can help provide high-quality diagnostic services, even if oncology care is not available in these counties, to enable better decision-making regarding treatment.

Overall, the availability and distribution of high-quality cancer care facilities and telehealth services varied significantly across the U.S., with 8.4% of the population not having access to proper cancer care due to geographic barriers. Thus, equitable access to oncology facilities and care is urgently needed to reduce geography-based disparities.

Journal reference:
  • Shalowitz, D. I., Hung, P., Zahnd, W. E., & Eberth, J. (2023). Pre-pandemic geographic access to hospital-based telehealth for cancer care in the United States. PLOS ONE 18(1); e0281071. doi:10.1371/journal.pone.0281071
Dr. Chinta Sidharthan

Written by

Dr. Chinta Sidharthan

Chinta Sidharthan is a writer based in Bangalore, India. Her academic background is in evolutionary biology and genetics, and she has extensive experience in scientific research, teaching, science writing, and herpetology. Chinta holds a Ph.D. in evolutionary biology from the Indian Institute of Science and is passionate about science education, writing, animals, wildlife, and conservation. For her doctoral research, she explored the origins and diversification of blindsnakes in India, as a part of which she did extensive fieldwork in the jungles of southern India. She has received the Canadian Governor General’s bronze medal and Bangalore University gold medal for academic excellence and published her research in high-impact journals.

Citations

Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Sidharthan, Chinta. (2023, February 05). Rural areas in the U.S. have significantly less access to telehealth and cancer care services. News-Medical. Retrieved on June 20, 2024 from https://www.news-medical.net/news/20230205/Rural-areas-in-the-US-have-significantly-less-access-to-telehealth-and-cancer-care-services.aspx.

  • MLA

    Sidharthan, Chinta. "Rural areas in the U.S. have significantly less access to telehealth and cancer care services". News-Medical. 20 June 2024. <https://www.news-medical.net/news/20230205/Rural-areas-in-the-US-have-significantly-less-access-to-telehealth-and-cancer-care-services.aspx>.

  • Chicago

    Sidharthan, Chinta. "Rural areas in the U.S. have significantly less access to telehealth and cancer care services". News-Medical. https://www.news-medical.net/news/20230205/Rural-areas-in-the-US-have-significantly-less-access-to-telehealth-and-cancer-care-services.aspx. (accessed June 20, 2024).

  • Harvard

    Sidharthan, Chinta. 2023. Rural areas in the U.S. have significantly less access to telehealth and cancer care services. News-Medical, viewed 20 June 2024, https://www.news-medical.net/news/20230205/Rural-areas-in-the-US-have-significantly-less-access-to-telehealth-and-cancer-care-services.aspx.

Comments

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment
Post

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.

You might also like...
AI-based liquid biopsy technology promises early detection of cancer recurrence