Spatial relationship between ambulatory surgery centers and colorectal cancer mortality within Pennsylvania, United States.

Public Health
N R GeyerE J Lengerich

Abstract

The objective of this study was to evaluate the spatial relationship between colorectal cancer (CRC) mortality and ambulatory surgery center (ASC) density in Pennsylvania's 67 counties. This was an ecological study. Age-adjusted CRC mortality rates were linked to ASC densities per 1,000 people. The data set was analyzed using global, local, and regional Moran's I, to test for randomness in CRC mortality and ASC density. CRC mortality rates (median: 15.30 per 100,000 of the US 2000 standard million population) exhibited hot spots in rural Pennsylvania counties. ASC densities (median: 0.35 providers/km2 per 1,000 people) showed hot spots in urban southeastern Pennsylvania and cold spots in northern Pennsylvania. CRC mortality rates tended to cluster in rural northern Pennsylvania counties; ASC density tended to cluster in urban southeastern counties, indicating a spatial disparity between needed and provided healthcare resources. There is a need for public health and health system changes to increase the availability of CRC services to rural communities.

References

Jul 15, 2015·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Rebecca L SiegelAhmedin Jemal
Apr 28, 2016·The New England Journal of Medicine·H Gilbert Welch, Douglas J Robertson
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Jun 11, 2017·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Kelly D BlakeRobert T Croyle
Nov 6, 2018·Spatial and Spatio-temporal Epidemiology·Liang MaoGuangran Deng

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