Patient‐centered outcomes of telehealth for the care of rural‐residing patients with urologic cancer
Erin R. Dwyer, Sarah K. Holt, Erika M. Wolff, Blair Stewart, Ronit Katz, Jason D. Reynolds, Adam J. Gadzinski, John L. Gore
Abstract
Abstract Background Patients residing in rural areas with urologic cancers confront significant obstacles in obtaining oncologic care. In the Pacific Northwest, a sizeable portion of the population lives in a rural county. Telehealth offers a potential access solution. Methods Patients receiving urologic care through telehealth or an in‐person appointment at the Fred Hutchinson Cancer Center in Seattle, Washington, were surveyed to assess appointment‐related satisfaction and travel costs. Patients' residences were classified as rural or urban based on their self‐reported ZIP code. Median patient satisfaction scores and appointment‐related travel costs were compared by rural versus urban residence within telehealth and in‐person appointment groups using Wilcoxon signed‐rank or χ 2 testing. Results A total of 1091 patients seen for urologic cancer care between June 2019 and April 2022 were included, 28.7% of which resided in a rural county. Patients were mostly non‐Hispanic White (75%) and covered by Medicare (58%). Among rural‐residing patients, telehealth and in‐person appointment groups had the same median satisfaction score (61; interquartile ratio, 58, 63). More rural‐residing than urban‐residing patients in the telehealth appointment groups strongly agreed that “Considering the cost and time commitment of my appointment, I would choose to meet with my provider in this setting in the future” (67% vs. 58%, p = .03). Rural‐residing patients with in‐person appointments carried a higher financial burden than those with telehealth appointments (medians, $80 vs. $0; p <.001). Conclusions Appointment‐related costs are high among rural‐residing patients traveling for urologic oncologic care. Telehealth provides an affordable solution that does not compromise patient satisfaction.