M Conlon1, M Hartman2, B Ballantyne3, N Aubin4, M Meigs5, A Knight6. 1. Epidemiology, Outcomes and Evaluation Research, Northeast Cancer Centre, Sudbury, ON. ; Northeast Cancer Centre, Health Sciences North, Sudbury, ON. ; Laurentian University, Sudbury, ON. ; Northern Ontario School of Medicine, Sudbury, ON. 2. Northeast Cancer Centre, Health Sciences North, Sudbury, ON. ; Cancer Care Ontario, Toronto, ON. 3. Northeast Cancer Centre, Health Sciences North, Sudbury, ON. ; Systemic Therapy Program, Northeast Cancer Centre, Sudbury, ON. ; Cambrian College, Sudbury, ON. 4. Northeast Cancer Centre, Health Sciences North, Sudbury, ON. 5. Epidemiology, Outcomes and Evaluation Research, Northeast Cancer Centre, Sudbury, ON. ; Northeast Cancer Centre, Health Sciences North, Sudbury, ON. 6. Northeast Cancer Centre, Health Sciences North, Sudbury, ON. ; Northern Ontario School of Medicine, Sudbury, ON. ; Cancer Care Ontario, Toronto, ON. ; Systemic Therapy Program, Northeast Cancer Centre, Sudbury, ON.
Abstract
BACKGROUND: To enhance cancer symptom management for residents of Sudbury-Manitoulin District, an ambulatory palliative clinic (pac) was established at the Northeast Cancer Centre of Health Sciences North. The pac is accessed from a medical or radiation oncology consultation. The primary purpose of the present population-based retrospective study was to estimate the percentage of cancer patients who died without ever having a medical or radiation oncology consultation. A secondary purpose was to determine factors associated with never having received one of those specialized consultations. METHODS: Administrative data was obtained through the Ontario Cancer Data Linkage Project. For each index case, we constructed a timeline, in days, of all Ontario Health Insurance Plan billing codes and associated service dates starting with the primary cancer diagnosis and ending with death. RESULTS: Within the 5-year study period (2004-2008), 6683 people in the area of interest with a valid record of primary cancer diagnosis died from any cause. Most (n = 5988, 89.6%) had 1 primary cancer diagnosis. For that subgroup, excluding those with a disease duration of 0 days (n = 67), about 18.4% (n = 1088) never had a consultation with a medical or radiation oncologist throughout their disease trajectory. Patients who were older or who resided in a rural area were significantly less likely to have had a consultation. CONCLUSIONS: Specific strategies directed toward older and rural patients might help to address this important access-to-care issue.
BACKGROUND: To enhance cancer symptom management for residents of Sudbury-Manitoulin District, an ambulatory palliative clinic (pac) was established at the Northeast Cancer Centre of Health Sciences North. The pac is accessed from a medical or radiation oncology consultation. The primary purpose of the present population-based retrospective study was to estimate the percentage of cancerpatients who died without ever having a medical or radiation oncology consultation. A secondary purpose was to determine factors associated with never having received one of those specialized consultations. METHODS: Administrative data was obtained through the Ontario Cancer Data Linkage Project. For each index case, we constructed a timeline, in days, of all Ontario Health Insurance Plan billing codes and associated service dates starting with the primary cancer diagnosis and ending with death. RESULTS: Within the 5-year study period (2004-2008), 6683 people in the area of interest with a valid record of primary cancer diagnosis died from any cause. Most (n = 5988, 89.6%) had 1 primary cancer diagnosis. For that subgroup, excluding those with a disease duration of 0 days (n = 67), about 18.4% (n = 1088) never had a consultation with a medical or radiation oncologist throughout their disease trajectory. Patients who were older or who resided in a rural area were significantly less likely to have had a consultation. CONCLUSIONS: Specific strategies directed toward older and rural patients might help to address this important access-to-care issue.
Entities:
Keywords:
Health services accessibility; medical records; palliative care; referral and consultation; rural health services
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