The Accessibility Of Medical Treatment For Children With Cancer Based On Perception And Decision Making

Accessibility research is one of the themes of health geography research,but existing studies have focused on objective accessibility to space,while neglecting the impact on the perception of subjects and subjectivity differences.The accessibility of medical services is an important factor affecting the survival rate of children with cancer,and is an important measure of the equity of distribution and efficient use of medical service resources.Childhood cancer is now the sixth largest global cancer burden after adult lung and liver cancers,stomach,colon and breast cancers,and is the second leading cause of death among children other than accidental deaths,with the Lancet Oncology Committee estimating that13.7 million new childhood cancer cases will occur globally between 2020 and 2050;at current levels of health system performance(including access and referral),61 million of these children will go undiagnosed,which accounts for 44.9 percent.The incidence of childhood cancer in China has been increasing significantly in recent years,and the survival rate of childhood cancer is much lower than that of developed countries in Europe and the United States,but the current research on childhood cancer in China is mainly focused on medicine and its related disciplines,and few scholars have conducted research on the accessibility of childhood cancer from a geographic perspective.Therefore,based on the perspective of health geography,this paper explores the current situation of accessibility of pediatric cancer patients through the subjective perceptions of their families and the factors that affect the subjective perceptions of accessibility of pediatric cancer patients by their families.Based on questionnaire data,the study explored the decision to seek medical care,the overall perception of access to medical care for children with cancer,and the accessibility profile of each component.The followings are the study found:Firstly,there is a process of spatial variation in the accessibility of medical care for children with cancer.It should be explored from "permanent residence-hospital","within hospital" and "temporary residence-hospital".Because of the special nature of medical treatment for children with cancer,they need to travel to and from the hospital and their usual place of residence many times,and some families of children with cancer have a temporary residence outside the hospital in order to take better care of their children.Secondly,the accessibility of “within hospital”: In this process,most of the cancer patients have good spatial and temporal accessibility and transportation accessibility,but in terms of information accessibility,due to the single information channel and lack of awareness of active access,they mainly rely on authoritative information channels(doctor’s recommendation),so the accuracy of information is high and the financial cost is stressful for some families,which has a negative impact on the perceived accessibility of medical care for sick children.Thirdly,the accessibility situation of “in-hospital”: In the stage,service and care are the main contents,and both service accessibility and care accessibility are higher in the hospital,where equipment and manual services are available in a shorter time and patients always have a better experience.Fourthly,the accessibility situation of “temporary hospital”: the temporary residences selected by the families of cancer patients in this process were distributed around the hospital,with close proximity and short commuting time,but different families of cancer patients used different strategies in choosing temporary residences,and there were differences in the spending on temporary residences,and thus the experiences were different.Fifthly,the main factors affecting the perceived accessibility of children with cancer within the province are no longer the traditional spatial and temporal accessibility and transportation accessibility,but economic accessibility and information accessibility are more influential.To address the accessibility problems of children with cancer,this paper propose strategies to optimize the accessibility of children with cancer from four aspects: government,society,hospitals,and their families.It aims to reveal the current situation of accessibility of cancer children,explore the factors affecting the perceived accessibility of cancer children,enrich the analytical framework and measurement dimensions of accessibility,promote the development of health geography in China,provide a scientific basis for optimizing the accessibility of cancer children,and provide some reference for subsequent researchers and policy makers.