p-BE index: modeling the structural relationship between the physical built environment and cancer outcomes within the biopsychosocial framework.

Cancer patients face complex challenges, not only the physical side effects of treatments but also because of the psychosocial consequences. These are further exacerbated by limited funding, inadequate infrastructure, and other difficulties in cancer care. Research has identified two key environments during cancer care: the residence and the oncology infrastructure (OI). While studies focus on the role of residence in accessibility and treatment adherence, less attention has been given to the OI, despite it being transversal for all patients within the same healthcare system. This study adopts a user-centered approach to explore the impact of the OI on physical, psychological, and social health. The p-BE index was developed and tested as a tool to evaluate both the OI and the patient’s residential area. The p-BE index has two components: the architectural p-BE index, which measures infrastructural and organizational characteristics of the OI, and the urban p-BE index, which evaluates the surrounding residential area. These scores are analyzed in relation to patients’ wellbeing and perceptions, designed to be integrated in the future with other databases, linking infrastructural and behavioral data. The findings showed no correlations between the urban p-BE index and wellbeing scores, suggesting that wellbeing may be more influenced by the characteristics of the residence or other factors. In contrast, the architectural p-BE index showed correlations in four of the six aspects examined, highlighting how inadequate infrastructure can negatively impact physical, psychological, and social wellbeing. This represents an unnecessary risk for patients and demonstrates the value of the digital twin as a valuable data source for health. The p-BE index helps evaluate patient experience in health environments and OI performance, with the goal of identifying avoidable risks and transforming infrastructure into an active tool for patient-centered healthcare.