Factors influencing access to palliative radiotherapy: a Norwegian population-based study
| Autor: | Bjørn Møller, Tor Åge Myklebust, Stein Kvaløy, Vidar Jetne, Linn M. Åsli, Sverre G. Levernes, Tom Børge Johannesen |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment MEDLINE Norwegian Health Services Accessibility 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) Palliative radiotherapy Neoplasms medicine Humans Radiology Nuclear Medicine and imaging Registries Intensive care medicine Survival analysis Aged Aged 80 and over Norway business.industry Palliative Care food and beverages Hematology General Medicine Middle Aged Survival Analysis language.human_language Radiation therapy Population based study Socioeconomic Factors Oncology 030220 oncology & carcinogenesis Quality of Life language Female Incurable cancer business |
| DOI: | 10.6084/m9.figshare.6198329.v2 |
| Popis: | Background: Palliative radiotherapy (PRT) comprises half of all radiotherapy use and is an effective and important treatment modality for improving quality of life in incurable cancer patients. We have described the use of PRT in Norway and aimed to identify and quantify the impact of factors associated with PRT utilization. Material and methods: Population-based data from the Cancer Registry of Norway identified 25,281 patients who died of cancer, 1 July 2009–31 December 2011. Additionally, individual-level data on socioeconomic status and community-level data on travel distance were collected. The proportion of patients who received PRT in the last two years of life (PRT2Y) was calculated, and multivariable logistic regression was used to determine factors that influenced the PRT2Y. Analyses of geographic variation in PRT use were also performed for the time period 2012–2016. Results: PRT2Y for all cancer sites combined was 29.6% with wide geographic variations (standardized inter-county range; 21.8–36.6%). Female gender, increasing age at death, certain cancer sites, short survival time, and previous receipt of curative radiotherapy were associated with decreased odds of receiving PRT. Patients with low education, those living in certain counties, or with travel distances 100–499 km, were also less likely to receive PRT. Patients with low household income (adjusted odds ratio (OR) = 0.63; 95% confidence interval (CI) = 0.56–0.72) and those diagnosed in hospitals without radiotherapy facility (OR = 0.70; 95% CI = 0.64–0.77) had especially low likelihood of receiving PRT. Significant inter-county variation in use of PRT remained during the time period 2012–2016. Conclusions: Despite a publicly funded, universal healthcare system with equity as a stated health policy aim, utilization of PRT in Norway is significantly associated with factors such as household income and availability of radiotherapy facility at the diagnosing hospital. Even after adjustments for relevant factors, unexplained geographic variations in PRT utilization exist. |
| Databáze: | OpenAIRE |
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