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Are visiting oncologists enough? A qualitative study of the needs of Australian rural and regional cancer patients, carers and health professionals
Author(s) -
Grimison Peter,
Phillips Fiona,
Butow Phyllis,
White Kate,
Yip Desmond,
Sardelic Frank,
Underhill Craig,
Tse Regina,
Simes Robyn,
Turley Kim,
Raymond Carmel,
Goldstein David
Publication year - 2013
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12014
Subject(s) - staffing , thematic analysis , focus group , metropolitan area , workforce , medicine , reimbursement , nursing , qualitative research , rural area , government (linguistics) , health care , family medicine , business , economic growth , sociology , social science , linguistics , philosophy , pathology , marketing , economics
Aim Survival rates for patients with cancer who live in rural and regional areas are worse than in metropolitan areas. This may be due to geographical isolation, delayed diagnosis, inadequate transport, lower socioeconomic status and workforce shortages. We conducted a qualitative study of rural patients, carers and health professionals. It aimed to identify concerns about, and strategies to optimize cancer care from those with direct experience. Methods Focus groups and structured interviews were conducted in N ew S outh W ales, A ustralia at four rural and regional hospitals ( B ega, D ubbo, T amworth and A lbury) and three metropolitan locations (in Sydney and the Jean Colvin Hostel) caring for rural patients. Sessions were audiotaped, transcribed and analyzed using thematic analysis. Results In total, 36 patients, 14 carers and 32 health professionals were interviewed in seven focus groups and 42 individual interviews. Concerns related to access to oncologists and other health professionals, and for services for investigation and treatment, the financial and social consequences of travel, unmet carer support needs and the hardships for health professionals. Strategies for improvement included comprehensive staffing and services coordinated in a hub and spoke model from adjacent larger centers, adequate reimbursement for travel and better carer support. Conclusion We identified broad concerns about regional and rural cancer care in A ustralia. The A ustralian F ederal G overnment commitment of $560 million to establish regional cancer centers is welcome; however, improvements must extend beyond infrastructure funding in large regional centers to comprehensive staffing in centers currently lacking resident oncologists, travel support and assistance for carers.