2055 - Assessing the Correlation between Travel Burden and Socioeconomic Status in Radiotherapy Access across Taiwanese Towns

W. H. Hsieh¹, S. F. Chen¹, T. Y. Lai^1,2, and Y. W. Hu²; ¹Department of Heavy Particles & Radiation Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, ²School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

Purpose/Objective(s): Existing research has shown that travel burden can significantly influence treatment choices for patients requiring radiotherapy. This study aims to assess the equity of travel burden for radiotherapy across different towns in Taiwan by analyzing the correlation between travel distances to radiotherapy facilities and the towns socioeconomic factors. Materials/

Methods: Socioeconomic data were sourced from government databases, including household income, population density, population change, the proportion of the elderly and education level, while the locations of radiotherapy facilities were obtained from the TASTRO (Taiwan Society of Therapeutic Radiology and Oncology) website. The shortest driving distances between geographic centers of towns and radiotherapy facilities were computed using the Google Maps application programming interface (API). Spearman’s partial correlation analysis was conducted to illustrate the relationship between socioeconomic factors and the travel distance to the nearest radiotherapy facilities.
Results: There are 349 towns (excluding remote islands) and 82 radiotherapy facilities in Taiwan, mostly located in western Taiwan. The median travel distance to the closest radiotherapy facilities is 11.5 km, ranging from 0.19 km to 102.7 km. The Spearman’s partial correlation analysis revealed weak but significant correlations between longer travel distances and lower socioeconomic indicators, such as median household income (r = -0.154, p < 0.01), proportion of the elderly (r = -0.134, p = 0.013), population density (r = -0.468, p < 0.01) and education level (r = -0.136, p = 0.01) while controlling for the other variables. However, when accounting for town population, these correlations between aforementioned socioeconomic factors and population-weighted travel distances were weakened and only the correlation with median household income (r = -0.134, p= 0.013) and proportion of the elderly (r = -0.106, p = 0.048) remained significant, suggesting a more balanced picture in access based on population size of towns.
Conclusion: The study demonstrated that towns with lower socioeconomic status tend to have poorer access to radiotherapy facilities. Although the distribution of these facilities in Taiwan appears to align with population size, it falls short of addressing socioeconomic disparities in access. This underscores the importance of better facility distribution to enhance health equity.