Analysis and stress-test of the spatial accessibility to German radiation oncology centers.

IF 2.5 3区医学 Q3 ONCOLOGY

Strahlentherapie und Onkologie Pub Date : 2025-07-24 DOI:10.1007/s00066-025-02435-7

Christoph Straube, Daniel Medenwald, Tim Holthaus

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引用次数: 0

Abstract

Background: Radiation therapy (RT) is a crucial component of cancer care. However, access to RT services varies significantly across regions. This study aims to assess and stress-test the geospatial distribution of radiation oncology centers (ROCs) in Germany.

Methods: Geospatial analysis was used to calculate travel times and distances and to calculate regional RT demand. A regional network analysis was also conducted. Simulation of local ROC closure and recalculation was conducted to stress-test the remaining RT capacities, resulting in a redistribution network analysis (ReDNA).

Results: While some regions have a higher concentration of ROCs than others, the average ROC usually serves a population of approximately 238,185 inhabitants. In urban regions, the average travel time to the nearest ROC was 7.9 min, compared to 11.4 min in rural regions. However, the heterogeneity increases when considering the second- or third-closest ROC, especially in rural regions. The regional ReDNA identified regions with high vulnerability to local ROC disruption. In these areas, the closure of a single ROC probably leads to significant increases in travel times for patients. Inhabitants of cities/towns in rural regions are specifically dependent on the serviceability of their ROC, with a relative increase in travel time by 171.9% if the currently nearest ROC is closed.

Discussion: For the first time, this study investigates the supply of RT services on a national level. The spatial accessibility of RT services is analyzed by regional types as well as by federal states. The novel ReDNA approach allows regions with potential vulnerabilities to be identified, resulting in a framework for stress-testing RT supply on a national level.

Conclusion: This research provides valuable insights into the spatial accessibility and vulnerability of radiation oncology services in Germany. Additionally, the methodology can also serve as a stress test and be applied to other regions and healthcare specialties to improve healthcare planning and patient outcomes.

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德国放射肿瘤学中心空间可达性分析与压力测试。

背景：放射治疗（RT）是癌症治疗的重要组成部分。然而，不同地区对RT服务的访问差异很大。本研究旨在评估和压力测试德国放射肿瘤学中心（ROCs）的地理空间分布。方法：采用地理空间分析方法计算出行时间和距离，计算区域RT需求。还进行了区域网络分析。模拟局部ROC闭合并重新计算以对剩余RT容量进行压力测试，从而进行再分配网络分析（ReDNA）。结果：虽然一些地区的ROC浓度高于其他地区，但平均ROC通常服务于约238,185名居民。在城市地区，到最近的ROC的平均旅行时间为7.9 min，而在农村地区为11.4 min。然而，当考虑第二或第三最接近的ROC时，异质性增加，特别是在农村地区。区域ReDNA识别出易受局部ROC破坏的区域。在这些地区，单个ROC的关闭可能会导致患者旅行时间的显着增加。农村地区的城镇居民特别依赖于其ROC的可用性，如果目前最近的ROC关闭，则旅行时间相对增加171.9%。讨论：本研究首次在国家层面上调查了RT服务的供给。以区域类型和联邦州为单位对公交服务的空间可达性进行了分析。新的ReDNA方法允许识别潜在漏洞的地区，从而形成一个在国家层面上对RT供应进行压力测试的框架。结论：本研究对德国放射肿瘤学服务的空间可达性和脆弱性提供了有价值的见解。此外，该方法还可以用作压力测试，并应用于其他地区和医疗保健专业，以改善医疗保健计划和患者结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Strahlentherapie und Onkologie 医学-核医学

CiteScore

5.70

自引率

12.90%

发文量

141

审稿时长

3-8 weeks

期刊介绍： Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research. Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.