Community Oncology: Patients’ perspective on a rural Australian medical oncology outreach service — ASN Events
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Community Oncology: Patients’ perspective on a rural Australian medical oncology outreach service (#216)

Mathew George 1 , Amy Prawira 1 , Wendy Allen 2 , Nidhin Thomas 2
  1. Medical Oncology, North West Cancer Centre, Tamworth, NSW, Australia
  2. Medical Oncology, Moree Hospital, Moree, NSW, Australia

Background
Community physician-based oncology centres are changing the landscape of medical oncology practice (1,2,3). Moree is a remote town in northern NSW approximately 640km from Sydney, to which the North West Cancer Centre provides an outreach community medical oncology service. In this study we explore the patients’ perspective and response.

Methods
41 patients attending the medical oncology outreach clinic were surveyed using an anonymous paper-based questionnaire. The questionnaire consists of 22 close-ended questions assessing level of patient satisfaction to various aspects of service provision. Cronbach Alpha score is measured to assess data reliability with respect to overall satisfaction with the service. We perform a subgroup analysis of patients who have received chemotherapy. 2 questions were dedicated to assessing patients’ response to outreach service in comparison to teleconference.

Results
93% of patients rate above average overall satisfaction with the service. A significantly higher satisfaction score is observed in patients who have received chemotherapy (p=0.001). 41% of surveyed patients have been involved in teleconference consultations. 71% such patients rated the experience as “good” or better.

Conclusion

Cancer patients in rural and remote communities are known to have poorer prognosis compared to their urban counterparts (4,5). Studies show that the greatest variability lies in patient trajectory prior to entry into the health care system (5). This study explores the patients’ perspective on the implementation of community oncology in a remote Australian community. We hope that increasing interest and implementation of the concept of community oncology would assist in improving patient access and, in future, their trajectory into mainstream specialist health care. Assessment of patient response to the use of teleconference as part of the outreach programme is also promising. This may be an area to further explore and exploit, in hope to improve service delivery and cost effectiveness of the rural and remote outreach service.

  1. Neuss MN et al, “Commentary: when it comes to chemotherapy, location matters”. J Oncol Pract. 2010 Sep;6(5):235-237
  2. Goldstein, M. “Systems perspective: the community-based oncology practice. Ensuring quality cancer care through the oncology workforce: sustaining research and care in the 21st century”. Presentation at: ASCO National Care Policy Forum Workshop. October 20-21, 2008.
  3. Guy GP Jr et al, “Visit duration for outpatient physician office visits among patients with cancer”. Am J Manag Care. 2012 May;18(5 Spec No. 2):SP49-56.
  4. Shugarman et al, "An Exploration of Urban and Rural Differences in Lung Cancer Survival Among Medicare Beneficiaries". Am J Public Health. 2008 July; 98(7): 1280–1287
  5. Report on lung cancer in Australia: Literature review and consultation on factors impacting on lung cancer outcomes. National lung cancer program, Cancer Australia 2011.