Lena A von Schuckmann1,2, Bernhard M Smithers3, Kiarash Khosrotehrani4, Vanessa L Beesley2, Jolieke C van der Pols1,2, Maria B Hughes2, Adele C Green2,5. 1. School of Public Health, The University of Queensland. 2. QIMR Berghofer Institute of Medical Research, Queensland. 3. Queensland Melanoma Project, Princess Alexandra Hospital, The University of Queensland. 4. UQ Centre for Clinical Research, Queensland. 5. CRUK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, UK.
Abstract
OBJECTIVE: To characterise use of support services in patients diagnosed with high-risk primary melanoma by their location of residence. METHODS: In a cross-sectional study of 787 patients with histologically-confirmed clinical stage 1B-2 melanoma, we estimated odds ratios (ORs) using regression models to assess the association of support service use with residence in rural, regional or urban areas. We also evaluated demographic and clinical correlates of support service use. RESULTS: Among 113 rural patients, 33 (29%) used support services around time of diagnosis compared to 88 (39%) of 224 regional participants and 164 of 448 (37%) urban participants. Regional participants more commonly used support services compared to rural participants (OR 1.84; CI 1.09-3.10), but there was no association with urban versus rural residence (OR 1.32; CI 0.82-2.13). As well, females (OR 1.58; CI 1.15-2.18), those <65 years (OR 1.96; CI 1.42-2.71), or with higher education (OR 2.30; CI 1.53-3.44), or those with T-stage 4B (OR 2.69; CI 1.36-5.32) were more likely to use support services than other patients. CONCLUSION: Use of support services is lower among rural patients and other sub-groups of primary melanoma patients who have poorer prognoses than others. Implications for public health: Appropriate triage to support services is required for rural and other vulnerable patient groups to ensure optimal patient care.
OBJECTIVE: To characterise use of support services in patients diagnosed with high-risk primary melanoma by their location of residence. METHODS: In a cross-sectional study of 787 patients with histologically-confirmed clinical stage 1B-2 melanoma, we estimated odds ratios (ORs) using regression models to assess the association of support service use with residence in rural, regional or urban areas. We also evaluated demographic and clinical correlates of support service use. RESULTS: Among 113 rural patients, 33 (29%) used support services around time of diagnosis compared to 88 (39%) of 224 regional participants and 164 of 448 (37%) urban participants. Regional participants more commonly used support services compared to rural participants (OR 1.84; CI 1.09-3.10), but there was no association with urban versus rural residence (OR 1.32; CI 0.82-2.13). As well, females (OR 1.58; CI 1.15-2.18), those <65 years (OR 1.96; CI 1.42-2.71), or with higher education (OR 2.30; CI 1.53-3.44), or those with T-stage 4B (OR 2.69; CI 1.36-5.32) were more likely to use support services than other patients. CONCLUSION: Use of support services is lower among rural patients and other sub-groups of primary melanomapatients who have poorer prognoses than others. Implications for public health: Appropriate triage to support services is required for rural and other vulnerable patient groups to ensure optimal patient care.
Authors: Wei-Yin Lim; Robin M Turner; Rachael L Morton; Marisa C Jenkins; Les Irwig; Angela C Webster; Mbathio Dieng; Robyn P M Saw; Pascale Guitera; Donald Low; Cynthia Low; Katy J L Bell Journal: BMC Health Serv Res Date: 2018-06-20 Impact factor: 2.655