Territorial organisation effects on the geography of healthcare pathways in hematological oncology. A case study in the region of Lyon (France)

Résumé En

Although the current health crisis has highlighted the limits of the French healthcare system, the question of improving patients’ healthcare and the relationship between patients and health professionals working at different geographical levels in patients’ care pathways is a much older issue. In France, the concomitant evolution of the population and of the healthcare supply has created a favorable context for thinking about improving patients' access to healthcare services and the management of their care pathways. This context leaded us to raise the issue of territory organization effects on patients' care pathways, both in their socio-demographic aspect and in that of the healthcare supply.This communication will address this issue through the case of the care pathways of patients treated at Léon Bérard Hospital in Lyon (France) between 2018 and 2019 for hematological cancers (leukemia, lymphoma or myeloma). The aim of this work was to analyze the relationships between territorial characteristics (urban hierarchy and network, communication network, spatial organization of healthcare services) and patients’ healthcare pathways in order to understand how territory organization impact patients’ mobility, in addition to their treatment protocol. We started from the assumption of territorial effects on patients’ mobility. In order to test this hypothesis, we implemented a three-step methodological approach:1. A statistical and cartographic analysis of territories characteristics and their healthcare supply relating to the care pathways for hematological cancers.2. An analysis of the characteristics and spatial behavior of 418 patients treated for hematological cancer at Léon Bérard Hospital in 2018 and 2019, based on data provided by Léon Bérard Hospital.3. A comparison between patients’ behavior and territories characteristics that enabled us to establish a typology of territories according to the medical and paramedical care of patients.