Older patients with pancreatic cancer, those in rural areas, and those from poorer socio-economic areas fare worse in terms of the quality of their care, according to research published in the Medical Journal of Australia.
The research analysed the experience of 1571 patients who were diagnosed with pancreatic cancer from July 2009 to June 2011 and notified to Queensland or New South Wales cancer registries.
A/Prof Rachel Neale and Ms Elizabeth Burmeister, of the QIMR Berghofer Medical Research Institute in Brisbane, developed a composite score that allowed them to rate the quality of care for Australian patients with pancreatic cancer. The study was done in collaboration with Cancer Council New South Wales and various hospitals in Queensland and NSW.
The score was devised as part of a broader population-based study that determined which factors affected the care received by these patients, and how survival could be improved by improving care. In Australia, pancreatic cancer is the tenth most common cancer and the fourth leading cause of cancer-related death. The researchers found that the quality of care score was lower in older patients, those who were more frail, who lived in rural areas rather than major cities and in the most socio-economically disadvantaged areas. The scores were higher when a specialist pancreatic surgeon was the first specialist a patient saw, rather than a general surgeon, and if they presented to a hospital with a high volume of pancreatic cancer cases each year.
Individual items of care were also examined, and it was found that fewer than one-third of patients received some recommended items of care. These included multidisciplinary team care, psychosocial support, options to participate in clinical trials, and being first seen by a hepatobiliary surgeon.
A/Prof Neale and her co-authors wrote that the variation of quality care based on geographical classification and socio-economic status was a "worrying finding".
"Distance causes particular challenges in Australia, but they should not be insurmountable; it has been reported, for example, that a multi-level approach ... can improve outcomes," they wrote.
"Systems of care need to be implemented which ensure that equitable treatment is provided for all Australian patients with pancreatic cancer."
Article: Factors associated with quality of care for patients with pancreatic cancer in Australia, Elizabeth A Burmeister, Dianne L O'Connell, Susan J Jordan, David Goldstein, Neil Merrett, David K Wyld, Vanessa L Beesley, Helen M Gooden, Monika Janda and Rachel E Neale, Medical Journal of Australia, doi: 10.5694/mja16.00567, published 21 November 2016.