Travel conditions.

Centralizing cancer care is better for everyone, right? Let’s look at how that model is working in the real world. Community cancer centers are struggling, as is cancer care in the communities they serve. This study shows that, in the Southeastern US, nearly a quarter of cancer patients drive over an hour to their “community” cancer center for treatment. Both patient and Medicare costs were higher among this population. Plus they had higher rates of hospitalization, often not at the hospital where they received cancer care. The increased rate of hospitalizations and healthcare utilization involved every phase of care from treatment to end-of-life care. This all outlines a paradigm shift that’s going to take more than hypofractionation to change directions. TBL: A by-product of “Big Oncology” may be the unintended deterioration of our community cancer infrastructure. | Rocque, J Clin Oncol 2019