Determining elderly-friendly radiation oncology clinics: a comparative analysis of accessibility and transport, physical environment, and privacy aspects

Abstract

Background: Radiotherapy is one of the main components of cancer treatment. However, its fractionated nature requires patients to make repeated visits to radiation oncology clinics. Considering the global increase in the elderly population and the growing number of older cancer patients, creating elderly-friendly radiation oncology clinics has become a healthcare priority. This study assesses the elderly-friendliness of radiation oncology clinics in Turkey, in terms of accessibility/transportation logistics, physical environment, and privacy considerations. Methods: Data were collected via a 48-item survey developed to assess the elderly-friendliness of radiation oncology clinics. The World Health Organization’s Age-friendly Primary Health Care Centers Toolkit was used as the framework for survey development. Statistical analyses were performed using Jamovi (Version 2.3.28) and JASP (Version 0.18.3). Results: A total of 155 physicians from 91 radiation oncology clinics participated in the survey. The median total comfort score was 26 (range:12-31). Clinics in private hospitals had significantly higher comfort scores (median=28, range:18-31) compared with public (median=25.5, range:12-31) and university hospitals (median=26.0, range:18-31) (p=0.02), while no significant difference was observed between public and university hospitals (p=0.6). Clinics that were considered comfortable according to the statement “Our clinic is comfortable for geriatric patients” had significantly higher scores regarding privacy (p <0.001), accessibility/transportation (p=0.001), physical environment (p=0.001), signage (p=0.001), and total comfort score (p<0.001). ROC analysis showed an AUC of 0.844 for the total score, with an optimal cut-off value of ≥26 (sensitivity: 72.97%, specificity: 76.47%, CI: 75.3%-91.1%, p<0.001). According to the cut-off point of 26, 4 of the 26 private hospitals 2 ARTICLE IN PRESS ARTICLE IN PRESS (15.3%), 15 of the 37 university hospitals (40.5%), and 14 of the 28 public hospitals (50.0%) scored below the threshold. Conclusion: This study aimed to highlight the importance of factors such as accessibility, physical environment, and privacy in determining the comfort of geriatric cancer patients and revealed significant differences among the types of radiation oncology clinics in Turkey. The initial findings of this survey indicate the need for certain adjustments to establish elderly-friendly clinics and ensure inter-clinic standardization, and they provide important insights for implementing the necessary improvements in radiation oncology clinics.