Factors and Practices that Enhance Delivery of Quality Cancer Care for Indigenous Australians across Primary Health Care and Hospital Settings in Queensland

  • Audra Karen De Witt

Student thesis: Doctor of Philosophy (PhD) - CDU

Abstract

The delivery of quality cancer care to Indigenous Australians is critical to improving cancer outcomes. However, little is known about this in the primary health care (PHC) setting. This study, based on health professionals’ perspectives, aims to identify facilitators and barriers to the provision of quality cancer care for Indigenous patients in Queensland and identify mechanisms for improvement. It examines extant systems and processes to identify Indigenous cancer patients in the PHC setting and analyses factors and practices that promote quality care. At the PHC service–hospital interface, it explores communication, continuity and care coordination and strategies for improvement, and determines time-points along cancer pathways when Indigenous patients may be most vulnerable to lack of continuity in care.

To identify Indigenous patients with a cancer diagnosis, a standardised telephone interview and medical chart audits were conducted in PHC centres (n = 10). Following this, semi-structured, face-to-face interviews with health professionals from six Indigenous PHC services (n = 17) and one tertiary hospital (n = 9) were completed. The study found no standardised methods to identify Indigenous cancer patients in the PHC setting. Based on participants’ feedback, Indigenous staff significantly contributed to the provision of follow-up cancer care by facilitating access to services and supporting patient needs. Timely communication, collaboration, streamlined processes, flexible care delivery and patient-centred care were perceived as vital in improving continuity and coordination of care between services. Additionally, gaps along the cancer pathway related to insufficient access to culturally competent care, differences in approaches to care and travel and resource challenges were also identified. Culturally competent care, adequately skilled staff and active involvement of PHC services can help overcome barriers to care across the cancer trajectory for Indigenous patients. Appropriate resourcing and evidence-based tools to systematically implement quality cancer care within PHC services are needed for sustained improvements in care pathways.
Date of Award2022
Original languageEnglish
SupervisorFrances Cunningham (Supervisor)

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