title: [Access to pediatric cancer care in Brazil: mapping origin-destination flows].
abstract: OBJECTIVE
  To analyze fl ows of travel between place of residence and health care services by children and adolescents with cancer.
  
  
  METHODS
  The flows of travel between place of residence and the health care service for children and adolescents receiving care in Brazil's Unifi ed Health System (SUS) were monitored between 2000 and 2007. The unit of analysis was the health care district. The geographical information system data and network methodology, by type of treatment received (chemotherapy and radiotherapy) and hospital admissions were used.
  
  
  RESULTS
  The SUS made 465,289 authorizations for chemotherapy, 29,151 for radiotherapy and 383,568 for hospital admissions for the treatment of children and adolescents with a diagnosis of cancer. The dominant fl ow formed 48 networks for chemotherapy, 53 for radiotherapy and 112 for hospital admissions. Most of the volume of treatment occurred in the health districts of Brazil's 12 largest cities (with strong links between them and each having an extensive area of direct infl uence accompanying the structure of the Brazilian urban system.
  
  
  CONCLUSIONS
  Identifying the networks formed by utilization of SUS facilities providing care for children and adolescents with cancer shows that overall most patients are covered by the existing networks. However, about 10% of travel occurs outside the dominant structure, indicating the need for alternative regionalization. These results show the importance of planning the distribution of services to meet the population's needs.
authors.affiliation: Instituto Nacional de Câncer, Serviço de Oncologia Pediátrica, Rio de JaneiroRJ.
authors.forename: Marilia Fornaciari
authors.initials: MF
authors.lastname: Grabois
authors.forename: Evangelina X G de
authors.initials: EX
authors.lastname: Oliveira
authors.forename: Marilia
authors.initials: M
authors.lastname: Sá Carvalho
mesh_terms: D000293:Adolescent; D002648:Child; D040362:Geographic Information Systems; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D009313:National Health Programs; D009369:Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data; D019037:Urban Health Services / Q000706:statistics & numerical data