Patricia C Valery1, Christina M Bernardes2, Audra de Witt3,4, Jennifer Martin5, Euan Walpole6, Gail Garvey3, Daniel Williamson7, Judith Meiklejohn2,8, Gunter Hartel2, Isanka U Ratnasekera2,9, Ross Bailie10. 1. Population Health, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Brisbane, Queensland, 4006, Australia. Patricia.Valery@qimrberghofer.edu.au. 2. Population Health, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Brisbane, Queensland, 4006, Australia. 3. Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia. 4. Queensland University of Technology, Faculty of Health, Translational Research Institute, Brisbane, Queensland, Australia. 5. School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia. 6. Princess Alexandra Hospital, Woolloongabba, Queensland, Australia. 7. Aboriginal and Torres Strait Islander Health Unit, Queensland Health, Brisbane, Queensland, Australia. 8. Orange Sky Australia, Brisbane, Queensland, Australia. 9. School of Medicine, The University of Queensland, Brisbane, Queensland, Australia. 10. University Centre for Rural Health, The University of Sydney, Lismore, NSW, Australia.
Abstract
PURPOSE: The role of general practitioners in cancer care has expanded in recent years. However, little is known about utilization of primary health care (PHC) services by patients with cancer, particularly among socio-economically disadvantaged groups. We describe utilization of PHC services by patients with cancer, and the nature of the care provided. The study focuses on a disadvantaged group in Australia, namely Indigenous Australians. METHODS: A retrospective audit of clinical records in ten PHC services in Queensland, Australia. Demographic and clinical data of Indigenous Australians diagnosed with cancer during 2010-2016 were abstracted from patient's medical records at the PHC services. The rates of cancer-related visits were calculated using person years at risk as a denominator. RESULTS: A total of 138 patients' records were audited. During 12 months following the cancer diagnosis, patients visited the PHC service on average 5.95 times per year. Frequency of visits were relatively high in remote areas and among socioeconomic disadvantaged patients (IRR = 1.87, 95%CI 1.61-2.17; IRR = 1.79, 95%CI 1.45-2.21, respectively). Over 80% of visits were for seeking attention for symptoms, wound care, and emotional or social support. Patients who did not undergo surgery, had greater comorbidity, received chemotherapy and/or radiotherapy, and male gender had significantly greater rate of visits than their counterparts. CONCLUSION: The frequency of utilization of PHC services, especially by patients with comorbidities, and the range of reasons for attendance highlights the important role of PHC services in providing cancer care. The reliance on PHC services, particularly by patients in remote and disadvantaged communities, has important implications for appropriate resourcing and support for services in these locations.
PURPOSE: The role of general practitioners in cancer care has expanded in recent years. However, little is known about utilization of primary health care (PHC) services by patients with cancer, particularly among socio-economically disadvantaged groups. We describe utilization of PHC services by patients with cancer, and the nature of the care provided. The study focuses on a disadvantaged group in Australia, namely Indigenous Australians. METHODS: A retrospective audit of clinical records in ten PHC services in Queensland, Australia. Demographic and clinical data of Indigenous Australians diagnosed with cancer during 2010-2016 were abstracted from patient's medical records at the PHC services. The rates of cancer-related visits were calculated using person years at risk as a denominator. RESULTS: A total of 138 patients' records were audited. During 12 months following the cancer diagnosis, patients visited the PHC service on average 5.95 times per year. Frequency of visits were relatively high in remote areas and among socioeconomic disadvantaged patients (IRR = 1.87, 95%CI 1.61-2.17; IRR = 1.79, 95%CI 1.45-2.21, respectively). Over 80% of visits were for seeking attention for symptoms, wound care, and emotional or social support. Patients who did not undergo surgery, had greater comorbidity, received chemotherapy and/or radiotherapy, and male gender had significantly greater rate of visits than their counterparts. CONCLUSION: The frequency of utilization of PHC services, especially by patients with comorbidities, and the range of reasons for attendance highlights the important role of PHC services in providing cancer care. The reliance on PHC services, particularly by patients in remote and disadvantaged communities, has important implications for appropriate resourcing and support for services in these locations.
Entities:
Keywords:
Cancer care; General practitioners (GPs); Indigenous Australians; Primary care
Authors: Audra de Witt; Veronica Matthews; Ross Bailie; Gail Garvey; Patricia C Valery; Jon Adams; Jennifer H Martin; Frances C Cunningham Journal: Int J Integr Care Date: 2020-06-08 Impact factor: 5.120
Authors: Vita Christie; Debbie Green; Janaki Amin; Christopher Pyke; Karen Littlejohn; John Skinner; Deb McCowen; Kylie Gwynne Journal: Int J Environ Res Public Health Date: 2021-06-04 Impact factor: 3.390