Paediatrics & child health · 2026
Far from home: the impact of geographic distance from a tertiary paediatric hospital in Canada on family stress and financial expenses.
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van Buuren Asia L, Best Laura M, Braschel Melissa, Udall Brittany, Sage Adam, Kim Michelle, Sernoskie Adam, Seaton Claire, McLaughlin Thomas, Carwana Matthew
Аннотация
OBJECTIVES: Many children and families living in rural/remote communities in Canada travel to receive health care at tertiary hospitals. While distance from the hospital has been shown to impact health outcomes, less is known about the psychosocial consequences. Our objective was to evaluate the association between distance travelled to receive inpatient care at a tertiary paediatric centre, and the financial and emotional costs of hospitalization.
METHODS: A prospective cohort study comparing demographics, financial costs and emotional stress associated with hospitalization (N = 148) of children admitted to a general paediatrics ward, comparing near (<50 km) and far (≥50 km) groups. Descriptive statistics, linear and logistic regressions were used to investigate the relationship between linear distance travelled and out-of-pocket costs or stress.
RESULTS: Forty percent of families travelled over 50 kilometres to the tertiary hospital. Multivariate linear and logistic regressions revealed that farther distance travelled predicted higher daily (95% CI [16,108] P = 0.009) and total (95% CI [8.4,551] P = 0.04) costs, as well as higher stress related to travel (95% CI [0.33,2.7]P = 0.013), finances (95% CI [0.99,3.5] P < 0.001 and isolation (95% CI[0.02, 2.6] P = 0.047).
CONCLUSION: These data suggest that families who travel farther to receive paediatric tertiary health care incur greater financial costs and stress, specifically related to finances, travel and isolation, compared to local families. These data highlight gaps in resources available. Increased stress may impact or defer decisions around when and where to present for care and should be considered within the context of additional factors that may be impacting a family's access to care.
METHODS: A prospective cohort study comparing demographics, financial costs and emotional stress associated with hospitalization (N = 148) of children admitted to a general paediatrics ward, comparing near (<50 km) and far (≥50 km) groups. Descriptive statistics, linear and logistic regressions were used to investigate the relationship between linear distance travelled and out-of-pocket costs or stress.
RESULTS: Forty percent of families travelled over 50 kilometres to the tertiary hospital. Multivariate linear and logistic regressions revealed that farther distance travelled predicted higher daily (95% CI [16,108] P = 0.009) and total (95% CI [8.4,551] P = 0.04) costs, as well as higher stress related to travel (95% CI [0.33,2.7]P = 0.013), finances (95% CI [0.99,3.5] P < 0.001 and isolation (95% CI[0.02, 2.6] P = 0.047).
CONCLUSION: These data suggest that families who travel farther to receive paediatric tertiary health care incur greater financial costs and stress, specifically related to finances, travel and isolation, compared to local families. These data highlight gaps in resources available. Increased stress may impact or defer decisions around when and where to present for care and should be considered within the context of additional factors that may be impacting a family's access to care.