Features associated with travel distance for radical cystectomy in Florida: Implications for access to care

•Investigated predictors of travel distance for radical cystectomy in Florida.•Those traveling >50 miles predominantly from disadvantaged counties in central FL.•Hispanic/Latino patients least likely to travel to a radical cystectomy center.•These data may support outreach efforts to increase access to radical cystectomy care. Characteristics associated with travel distance for radical cystectomy (RC) remain incompletely defined but are needed to inform efforts to bridge gaps in care. Therefore, we assessed features associated with travel distance for RC in a statewide dataset. We identified RC patients in the Florida Inpatient Discharge dataset from 2013 to 2019. Travel distance was estimated using zip code centroids. The primary outcome was travel >50 miles for RC. Secondary outcomes included inpatient mortality, nonhome discharge, and inpatient complications. U.S. County Health Rankings were included as model covariates. Mixed effects logistic regression models accounting for clustering within hospitals were utilized. We identified 4,209 patients, of whom 2,284 (54%) traveled 50 miles. Patients who traveled >50 miles primarily lived in central and southwest Florida. Following multivariable adjustment, patients traveling >50 miles were less likely to be Hispanic/Latino (odds ratio [OR] 0.35, 95% CI: 0.23–0.51), and more likely to reside in a county with the lowest health behavior (OR 6.48, 95% CI: 3.81–11.2) and lowest socioeconomic (OR 7.63, 95% CI: 5.30–11.1) rankings compared to those traveling 50 miles was associated with treatment at a high-volume center and significantly lower risks of inpatient mortality, nonhome discharge, and postoperative complications (all P < 0.02). These data identify characteristics of patients and communities in the state of Florida with potentially impaired access to RC care and can be used to guide outreach efforts designed to improve access to care.