title: Geographic access to hematopoietic cell transplantation services in the United States.
abstract: The use of hematopoietic cell transplantation (HCT) has risen in recent years and additional increases are projected in the near- and long-term future. The complex nature of HCT, along with its potentially rigorous follow-up care requirements, presents numerous potential barriers to accessing this important service (for example, financial considerations, donor availability and sociodemographic factors). The distance between a patient and an HCT facility also appears to be an important factor in both HCT use and outcomes. We provide the first comprehensive and detailed evaluation of geographic access to HCT services for the adult (18+ years) and pediatric (0-17 years) populations in the United States. Population-level access is examined as well as detailed gender, race/ethnicity and age breakdowns. Generally, access to HCT services appears to be quite high throughout the United States, as 48%, 78.6% and 94.7% of the 18+ years age population has 30, 90 and 180 min access (respectively) to an adult HCT facility and 42.5%, 72% and 91.5% of the 0-17 years age population has 30, 90 and 180 min access (respectively) to a pediatric facility.
authors.affiliation: Department of Geography and Geoinformation Science, George Mason University, Fairfax, VA, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: Delamater
authors.affiliation: Department of Oncology, Wayne State University, Karmanos Cancer Center, Detroit, MI, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Uberti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration / Q000639:trends; D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States