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)317-327
    Number of pages11
    JournalSupportive Care in Cancer
    Volume28
    Issue number1
    Early online date2 May 2019
    DOIs
    Publication statusPublished - Jan 2020

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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, P. C., Bernardes, C. M., de Witt, A., Martin, J., Walpole, E., Garvey, G., ... Bailie, R. (2020). Patterns of primary health care service use of Indigenous Australians diagnosed with cancer. Supportive Care in Cancer, 28(1), 317-327. https://doi.org/10.1007/s00520-019-04821-1
    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. 2020 ; Vol. 28, No. 1. pp. 317-327.
    @article{f7744633ba8c46bcbd0485f5843f9795,
    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.",
    keywords = "Cancer care, General practitioners (GPs), Indigenous Australians, Primary care",
    author = "Valery, {Patricia C.} and Bernardes, {Christina M.} and {de Witt}, Audra and Jennifer Martin and Euan Walpole and Gail Garvey and Daniel Williamson and Judith Meiklejohn and Gunter Hartel and Ratnasekera, {Isanka U.} and Ross Bailie",
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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 2020, 'Patterns of primary health care service use of Indigenous Australians diagnosed with cancer', Supportive Care in Cancer, vol. 28, no. 1, pp. 317-327. 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, Vol. 28, No. 1, 01.2020, p. 317-327.

    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

    PY - 2020/1

    Y1 - 2020/1

    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.

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    KW - Cancer care

    KW - General practitioners (GPs)

    KW - Indigenous Australians

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