Arch Hellen Med, 26(6), November-December 2009, 808-817
Regional distribution of oncology specific infrastructure for the care of cancer patients in Greece
K. SOULIOTIS,1,2 K. ATHANASAKIS,2 C. GOLNA,2,3 C. PAPADOPOULOU,2 J. KYRIOPOULOS2
OBJECTIVE The objective of this study was to assess the geographical distribution of the nationally available resources (public and private) for the diagnosis and treatment of patients with cancer in Greece, in order to identify disparities in capacity between various geographic regions that might influence equality of access to effective cancer care.
METHOD A questionnaire-based survey was conducted with public and private sector hospitals in Greece to record their capacity to diagnose and/or treat cancer. The questionnaire items, among other parameters, focused on the availability of oncology beds and day clinic beds. The survey questionnaire was piloted with a small sample. Data were clustered according to geographic region and compared with the percentage of the population in each region, as recorded in the 2001 census.
RESULTS Excess clustering of oncology beds was recorded mainly in the region of Attica (namely the cities of Athens and Pireus), followed by Central Macedonia (an area that includes Thessaloniki). For three regions, mainly rural, accounting in total for 16.3% of the Greek population, no oncology beds were recorded. Day clinic beds were also clustered, mainly in Attica and Central Macedonia. For the rest of Central Greece, Western Macedonia and the Ionian Islands, no day clinic beds were recorded.
CONCLUSIONS Clustering of oncology specific resources exceeds the spatial concentration pattern of healthcare services observed in Greece. Major discrepancies were observed in the distribution of resources in favor of large urban areas. Oncology specific resources are available only in the regions where medical schools maintain university hospitals. Geographical misdistribution is a major contributor to inequalities of access to health care. Fairer allocation of resources according to population distribution could contribute to achieving earlier access to effective health care, thus reducing the burden of the disease, lowering the cost for seeking adequate treatment for the household and ensuring equality in access to oncology services.
Key words: Cancer, Cancer care, Health system infrastructure, Oncology specific resources, Regional distribution.