In-Person Visits More Costly, Time Consuming for Rural Patients Than Telemedicine Visits

Patients from out-of-state or living in rural Washington state experienced significant travel time, cost, and time away from work to receive outpatient urologic cancer care, according to an abstract presented at the 2020 American Society for Clinical Oncology (ASCO) Virtual Scientific Program.

Patients were treated at the University of Washington Urology Clinic; however, telemedicine visits proved a fruitful option to replace in-person care by eliminating these significant travel burdens, cost, and time away from work incurred through this research.

“These individuals face barriers to accessing cancer care, including prevalent poverty and substantial travel burden to seeing cancer providers,” wrote the researchers. “We aimed to assess the impact of a rurally focused telemedicine program on patient outcomes in our urologic oncology outpatient clinic.”

Overall, 133 patients completed in-person visits compared to only 7 patients who completed telemedicine appointments. The data found that the in-person population traveled for a one-way median of 200 minutes with an interquartile range (IQR) of 150-325 minutes. More, one-way travel miles for this population was a median of 145 miles with an IQR of 81-381 miles.

Total travel costs in US dollars was a median of $100 with an IQR of $40-$500. A total of 13 patients spent more than $1000 in travel expenses. Further, 32 patients (24%) needed air travel and 42 patients (32%) needed to stay in a hotel. One patient took a day off to be seen at the University of Washington Urology Clinic.

Comparatively, there was no data for the patients who opted for telemedicine visits because there was no need for them to travel to the clinic.

A total of 291 eligible patients were invited from June 2019 to February 2020 to complete a post-visit survey assessing satisfaction, travel time, costs, and work absenteeism. With 140 total respondents, patient-reported outcomes between in-person versus telemedicine appointments were compared.

Overall, patients were evaluated for prostate cancer (57%), urothelial cancer (24%), kidney cancer (18%), and testis cancer (1%).

Median age for the patients who completed the post-visit survey was 68 years old, with 86% of respondents being male, and 69% being Caucasian. More, 87 patients were from rural Washington state, with the remaining patients reporting out-of-state residency.

Reference:

Gadzinski AJ, Abarro IO, Stewart B, et al. The impact of telemedicine on patient-reported outcomes in urologic oncology. Presented at: 2020 ASCO Virtual Scientific Program; May 29, 2020. Abstract e14154.