Determining Burden of Commuting for Treatment Using Online Mapping Services - A Study of Breast Cancer Patients.

For patients with breast cancer who must frequent medical centers for care, commuting is a significant burden. This burden could affect their decisions during treatment. We developed a method to use census tracts and zip codes to determine commuting burden for patients with breast cancer with online mapping services, while protecting patient addresses from third parties. We found that patients who lived farther from Vanderbilt had fewer unique appointment days and more appointments scheduled per day. Total burden decreased over time after diagnosis, but advanced stage patients had sustained high levels of commute time until ten months after diagnosis. Additionally, we found that patients who lived far from Vanderbilt were less likely to receive radiotherapy from Vanderbilt. With the amount of work patients put into traveling for care, understanding commuting burden could help healthcare organizations form strategies to improve access to care and compliance with care plans.