Planning Towards Equal Spatial Accessibility of NCI Cancer Centers Across Geographic Areas and Demographic Groups in the U.S.
The Cancer Centers designated by the National Cancer Institute (NCI) form the “backbone” of the cancer care system in the United States. Awarded via a peer-review process and being re-evaluated every 3 to 5 years, an NCI Cancer Center receives substantial financial support from NCI grants. When the quality standard is not compromised, we argue that an additional criterion for improving and promoting equal accessibility should be factored into the designation and planning process of NCI Cancer Centers. With the help of regression and dummy variables, this research evaluates geographic disparities in spatial accessibility of the NCI Cancer Centers across geographic area, divisions and urbanicity. It also evaluates demographic disparities across ethnic and poverty groups. Then this research examines two planning objectives to minimize the inequalities in accessibility. One is to minimize the geographic inequality while the other is to minimize the racial disparities. Two types of optimization scenarios are considered in this exploratory research for the objective of minimizing inequality of spatial accessibility. One is to allocate additional resources to existing NCI Cancer Centers, and the other is to designate new centers from the most likely candidates (e.g., existing academic medical centers or AMCs). Quadratic Programming (QP) and Particle Swarm Optimization (PSO) are used to solve different optimization problems. Several scenarios are used to illustrate the impact of optimization on reducing geographic and demographic disparities. Results from the study may inform the public policy decision making process in planning of the NCI Cancer Centers towards equal accessibility.
NCI Cancer Center, geographic disparities, demographic disparities, optimization, equal accessibility, Quadratic Programming, Particle Swarm Optimization.
Networked Digital Library of Theses and Dissertations