Coordinating care for people with colorectal cancer: a population-based survey of patient experiences in NSW — ASN Events
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Coordinating care for people with colorectal cancer: a population-based survey of patient experiences in NSW (#307)

Ivana Durcinoska 1 2 , Jane M Young 2 3 , Michael Solomon 3
  1. Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  2. Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
  3. RPA Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW, Australia

Background

Providing coordinated care is a priority for health service improvement. Understanding which factors impact care coordination is crucial for service improvement. This study investigated patient- and system-related predictors of experiencing poorly coordinated care, and identified patient preferences for resources to assist care coordination. 

Methods

This population-based cross-sectional survey recruited patients with newly diagnosed colorectal cancer, notified to the NSW Central Cancer Registry between November 2012 and May 2013. Participants completed the Patient Experience of Cancer Care Coordination questionnaire 6 months post diagnosis. Multivariate regression models were used to identify significant, independent predictors of poor care coordination.

Results

Of 1027 patients contacted, 560(55%) participated. Respondents had a mean age of 68 years, 60% male and 24% rectal cancer. Care coordination scores (mean 76.1,SD 10.9) were normally distributed . Patients' experiencing poorly coordinated care were more likely to have little or no understanding of the health system (β-4.4, 95% CI:-6.18,-2.49,p=<0.001), didn't have a regular GP (β-4.1, 95% CI:-8.17,-0.21,p=0.05) and had over 2 comorbidities (β-4.57, 95%CI:-7.44,-1.69,p=0.01). Additionally, patients' who didn’t receive a written pre-treatment plan (β-4.15, 95% CI:-6.02,-2.28,p=<0.001) and those who didn’t  see a cancer care coordinator or specialist cancer nurse during treatment (β-3.29, 95% CI:-5.31,-1.27,p=0.001) experienced poorer care coordination. The most preferred resources to enhance care coordination were, information packs (95%), written plans before and after treatment (91%), access to a cancer care coordinator by phone post discharge (87%) and copies of their medical records (electronic 90%, paper 87%).

Conclusions

There is wide variation in experience of care coordination across NSW. Strategies providing timely information through the use of pre-treatment plans as well as improving access to care coordinators may improve patient experiences, particularly in patients with other risk factors for poor care coordination.

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