Report: Not all cancer care in NC is created equal

By Stephanie Carson
Public News Service-NC

CHAPEL HILL — The quality of cancer care you receive in North Carolina could depend on where you live. That’s the conclusion of two studies recently published in the North Carolina Medical Journal.

Photo courtesy National Cancer Institute UNC research found that proximity to care impacts publicly insured patient's ability to continue cancer treatment.

Photo courtesy National Cancer Institute
UNC research found that proximity to care impacts publicly insured patient’s ability to continue cancer treatment.

Stephanie Wheeler, assistant professor in health policy and management at the Gillings School of Global Public Health at UNC-Chapel Hill, analyzed people on Medicaid in the state to evaluate the frequency and availability of chemotherapy treatments. 

“Distance does matter,” Wheeler said. “We found that in urban areas the further away that you live from a radiation provider, the lower odds you have of receiving radiation.”

One surprising outcome of Wheeler’s research was that rural patients, living less than 10 miles from their provider, are less likely to receive therapy than those living further away. She attributes that to the fact that people who live in rural areas are accustomed to driving further for their needs. 

A separate study released this summer from the American Society of Clinical Oncology found there is a projected shortage of 1,500 physicians over the next 10 years to care for cancer patients. Wheeler also points out rural areas often have fewer specialists in close proximity. 

“There’s quality of care issues everywhere,” said Wheeler. “What some of the issue might be in rural settings is sometimes the oncologist practicing in those settings are more often generalists.”

The study also found two-thirds of small oncology practices reported they were likely to merge, sell or close within a year. The report suggests an expansion of tele-medicine to give patients greater access to specialists and reducing the instability of payments from publicly-insured patents that have a disproportionate impact on small community practices.

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