Patterns of primary health care service use of Indigenous Australians diagnosed with cancer

Patricia C. Valery, Christina M. Bernardes, Audra de Witt, Jennifer Martin, Euan Walpole, Gail Garvey, Daniel Williamson, Judith Meiklejohn, Gunter Hartel, Isanka U. Ratnasekera, Ross Bailie

Research output: Contribution to journalArticleResearchpeer-review

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.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalSupportive Care in Cancer
DOIs
Publication statusE-pub ahead of print - 2 May 2019

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Health Services
Primary Health Care
Vulnerable Populations
Neoplasms
Comorbidity
Clinical Audit
Queensland
Social Support
General Practitioners
Medical Records
Radiotherapy
Demography
Drug Therapy
Wounds and Injuries

Cite this

Valery, Patricia C. ; Bernardes, Christina M. ; de Witt, Audra ; Martin, Jennifer ; Walpole, Euan ; Garvey, Gail ; Williamson, Daniel ; Meiklejohn, Judith ; Hartel, Gunter ; Ratnasekera, Isanka U. ; Bailie, Ross. / Patterns of primary health care service use of Indigenous Australians diagnosed with cancer. In: Supportive Care in Cancer. 2019 ; pp. 1-11.
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title = "Patterns of primary health care service use of Indigenous Australians diagnosed with cancer",
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.",
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Valery, PC, Bernardes, CM, de Witt, A, Martin, J, Walpole, E, Garvey, G, Williamson, D, Meiklejohn, J, Hartel, G, Ratnasekera, IU & Bailie, R 2019, 'Patterns of primary health care service use of Indigenous Australians diagnosed with cancer' Supportive Care in Cancer, pp. 1-11. https://doi.org/10.1007/s00520-019-04821-1

Patterns of primary health care service use of Indigenous Australians diagnosed with cancer. / Valery, Patricia C.; Bernardes, Christina M.; de Witt, Audra; Martin, Jennifer; Walpole, Euan; Garvey, Gail; Williamson, Daniel; Meiklejohn, Judith; Hartel, Gunter; Ratnasekera, Isanka U.; Bailie, Ross.

In: Supportive Care in Cancer, 02.05.2019, p. 1-11.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Patterns of primary health care service use of Indigenous Australians diagnosed with cancer

AU - Valery, Patricia C.

AU - Bernardes, Christina M.

AU - de Witt, Audra

AU - Martin, Jennifer

AU - Walpole, Euan

AU - Garvey, Gail

AU - Williamson, Daniel

AU - Meiklejohn, Judith

AU - Hartel, Gunter

AU - Ratnasekera, Isanka U.

AU - Bailie, Ross

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N2 - 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.

AB - 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.

KW - Cancer care

KW - General practitioners (GPs)

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