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Distance to Radiotherapy and Demand – Projection of the Effects of Establishing New Radiotherapy Facilities in Poland by 2025

Adam Michał Czerwiński
Adam Michał Czerwiński
   | Apr 01, 2019
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Published Online: Apr 01, 2019
Page range: 40 - 52
DOI: https://doi.org/10.2478/ceej-2018-0002
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© 2017 A.M. Czerwiński, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Fig. 1

Linear accelerator locations in 2012 and 2016 and planned locations in 2025
Linear accelerator locations in 2012 and 2016 and planned locations in 2025

Fig. 2

Observed overall EBRT utilisation rate (a), and fitted values of the best overall EBRT utilisation spatial model (standard(1),power*) in 2012 with trend and signal (b), in 2012 with trend (c) and in 2025 with trend (d)
Observed overall EBRT utilisation rate (a), and fitted values of the best overall EBRT utilisation spatial model (standard(1),power*) in 2012 with trend and signal (b), in 2012 with trend (c) and in 2025 with trend (d)

Fig. 3

Fitted EBRT utilisation rates of the best overall and cancer-specific models in relation to their respective distance measures
Fitted EBRT utilisation rates of the best overall and cancer-specific models in relation to their respective distance measures

Fig. 4

Projected change of expected EBRT utilisation rates for counties between 2012 (trend) and 2025 according to the best overall spatial model
Projected change of expected EBRT utilisation rates for counties between 2012 (trend) and 2025 according to the best overall spatial model

Results of the cancer-specific models with the best fit according to the AIC

EBRT utilisation rateCentral nervous SystemLower gastrointestinal tractFemale genital organsHead and neckBreastTrachea, bronchus and lungProstateOther
Distance Functional measure formstandard(3) powerstandard(1) exponential*gravitational(3) exponentialgravitational(3) exponentialstandard(1) exponentialstandard(2) exponential*standard(1) powergravitational(1) exponential
ß0Coefficient0.7100.2690.4380.6810.6180.4660.6200.258
Cl(95%)(0.521,0.900)(0.244,0.285)(0.388,0.487)(0.617,0.745)(0.583,0.652)(0.415,0.517)(0.543,0.697)(0.232,0.284)
p-value (Wald)<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
y1Coefficient-0.073-0.0008-0.005-0.008-0.0011-0.0011-0.020-0.004
CI(95%)(-0.117, -0.030)(-0.0011,-0.0003)(-0.008,-0.001)(-0.012,-0.003)(-0.0017,-0.0004)(-0.0017,-0.0003)(-0.040, -0.0003)(-0.006, -0.002)
p-value (Wald)0.001<0.0010.005<0.001<0.0010.0030.046<0.001
indCoefficient--0.037---0.056--
CI (95%)-(-0.072,-0.001)---(0.017,0.095)--
p-value (Wald)0.044---0.005-
ACoefficient-0.1320.3560.3210.2700.3730.5600.4860.682
Cl (95%)(-0.288, 0.022)(0.227,0.485)(0.189,0.452)(0.134,0.405)(0.245,0.500)(0.452,0.666)(0.370,0.601)(0.593,0.772)
p-value (Wald)0.104<0.001<0.001<0.001<0.001<0.001<0.001<0.001
AIC-186.87-822.05-536.84-297.09-487.41-670.97-193.55-980.25
AlC(linear)-186.26-796.21-517.20-248.70-456.69-579.02-141.71-822.23
SRMSE0.4740.3470.3150.2810.2180.2380.3270.281

Prognosis results for 2025

ModelBase-case utilisationPrognosis utilisationUtilisation change (%)
Overall0.4530.466+3.05
Cancer-specific0.4640.479+3.15
Central nervous system0.5100.542+6.30
Lower gastrointestinal tract0.2680.273+1.95
Female genital organs0.4610.479+3.88
Head and neck0.8130.828+1.88
Breast0.8010.819+1.33
Trachea, bronchus and lung0.5230.561+7.30
Prostate0.7700.774+0.46
Other0.2610.270+3.74

Malignant neoplasm groups defined for the purpose of cancer-specific utilisation rates

Cancer groupICD-10*Utilisation rate in 2012Counties with 0 courses in 2012
1.Central nervous systemC70-C720.49318
2.Melanoma of skinC430.260108
3.Head and neckC00-C14, C30-C320.7992
4.Trachea, bronchus and lungC33, C340.5200
5.BreastC50, D050.7870
6.Lower gastrointestinal tractC18-C210.2642
7.Upper gastrointestinal tractC15, C16, C22-260.13841
8.ProstateC610.7173
9.Female genital organsC53, C54, C56, C570.4583
10.KidneyC64-C660.15983
11.BladderC670.15778
12.ThyroidC730.870210
13.TesticleC620.136211
14.OtherC17, C37-C41, C45-C49, C51, C52, C55, C58, C60, C63, C68, C69, C74-C80, C970.5471

Comparison of the results of the SEM and OLS overall EBRT utilisation models with the best fit according to the AIC criterion

Distance measure Functional form Model versionstandard(1) power*
SEMOLS
β0Coefficient0.4520.501
CI( 95%)(0.405, 0.498)(0.461, 0.540)
p-value (Wald)<0.001<0.001
γ1Coefficient-0.024-0.038
CI( 95%)(-0.035, -0.012)(-0.048, -0.027)
p-value (Wald)<0.001<0.001
indCoefficient-0.046-0.086
CI( 95%)(-0.085, -0.008)(-0.132, -0.040)
p-value (Wald)0.018<0.001
λCoefficient0.710-
CI(95%)(0.625, 0.795)-
p-value (Wald)<0.001-
AIC−1,247.33−1,062.53
SRMSE0.1200.163
Projected utilisation rate (2025)0.4660.473
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