The Impact of Distance to Care on Unmet Nonmedical Costs Among Families of Children with Cancer
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not-yet-known not-yet-known not-yet-known unknown Background : Families of children with cancer often incur substantial nonmedical costs for travel, lodging, and food when accessing specialized care. These costs can contribute to health-related financial strain, yet the relationship between distance to care and unmet nonmedical costs remains poorly understood. Procedure: We conducted a retrospective cohort study of families applying for support from Children’s Cancer Partners of the Carolinas (CCPC) between August 2011 and March 2024. Eligible participants included families of children with cancer from North and South Carolina with complete data on zip code, treatment center, and reimbursed costs. Distance to primary treatment center was calculated in miles and minutes. Outcomes included total unmet nonmedical costs (USD), and the frequency, magnitude, and types of reimbursed costs. Results : Among 1,890 children, the mean age was 10.4 years (SD 5.4), most were male (56%), White (51%), and publicly insured (56%). The most common diagnosis was hematologic malignancy (49%). One-fifth (22%) lived in rural areas. Median unmet nonmedical costs were $1,094/family [IQR $320-2,379] and represent costs of land travel, food, and leisure. Median travel distance was 37.8 miles [IQR 21.3-71.4] or 46.9 minutes [IQR 31.0-81.3] each way. After adjusting for potential confounders, each additional travel minute was associated with $9.14 higher unmet nonmedical costs (95% CI: 6.91, 11.37), and each additional mile was associated with $8.85 higher costs (95% CI: 6.69, 11.00). Conclusions and Relevance : Longer distance to cancer care is associated with increased total unmet nonmedical costs. Additional resources are needed to reduce travel-related cost barriers for families living far from pediatric cancer centers.
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Abstract
not-yet-known not-yet-known not-yet-known unknown Background : Families of children with cancer often incur substantial nonmedical costs for travel, lodging, and food when accessing specialized care. These costs can contribute to health-related financial strain, yet the relationship between distance to care and unmet nonmedical costs remains poorly understood. Procedure: We conducted a retrospective cohort study of families applying for support from Children’s Cancer Partners of the Carolinas (CCPC) between August 2011 and March 2024. Eligible participants included families of children with cancer from North and South Carolina with complete data on zip code, treatment center, and reimbursed costs. Distance to primary treatment center was calculated in miles and minutes. Outcomes included total unmet nonmedical costs (USD), and the frequency, magnitude, and types of reimbursed costs. Results : Among 1,890 children, the mean age was 10.4 years (SD 5.4), most were male (56%), White (51%), and publicly insured (56%). The most common diagnosis was hematologic malignancy (49%). One-fifth (22%) lived in rural areas. Median unmet nonmedical costs were $1,094/family [IQR $320-2,379] and represent costs of land travel, food, and leisure. Median travel distance was 37.8 miles [IQR 21.3-71.4] or 46.9 minutes [IQR 31.0-81.3] each way. After adjusting for potential confounders, each additional travel minute was associated with $9.14 higher unmet nonmedical costs (95% CI: 6.91, 11.37), and each additional mile was associated with $8.85 higher costs (95% CI: 6.69, 11.00). Conclusions and Relevance : Longer distance to cancer care is associated with increased total unmet nonmedical costs. Additional resources are needed to reduce travel-related cost barriers for families living far from pediatric cancer centers.
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Mallory F. Happ, Julie M. Thamby, Vanessa E. Miller, et al.
The Impact of Distance to Care on Unmet Nonmedical Costs Among Families of Children with Cancer. Authorea. 19 August 2025.
DOI: https://doi.org/10.22541/au.175562133.30864810/v1
DOI: https://doi.org/10.22541/au.175562133.30864810/v1
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