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Patterns of primary health care service use of Indigenous Australians diagnosed with cancer

  • Patricia C. ValeryEmail author
  • Christina M. Bernardes
  • Audra de Witt
  • Jennifer Martin
  • Euan Walpole
  • Gail Garvey
  • Daniel Williamson
  • Judith Meiklejohn
  • Gunter Hartel
  • Isanka U. Ratnasekera
  • Ross Bailie
Original Article

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 Primary care General practitioners (GPs) Indigenous Australians 

Notes

Acknowledgements

The authors would like to thank Aboriginal Community Controlled Health Organizations and primary health care staff at participating centers for their support for this study.

Authors contributions

PCV, RB, GG, and AdW contributed to the conception and design of the study. PCV performed the data analysis and takes responsibility for the integrity and the accuracy of the data. PCV drafted the report. All authors contributed the interpretation of data, revising draft critically for important intellectual content, and approved the final version.

Funding information

This work was supported by the National Health and Medical Research Council (no. 1044433). PCV was supported by the National Health and Medical Research Council (Career Development Fellowship no. 1083090). ADW was sup-ported by an Australian Postgraduate Award Scholarship from Charles Darwin University and a top up scholarship from Menzies School of Health Research. GG was supported by a National Health and Medical Research Council Early Career Research Fellowship (no. 1105399). This study was undertaken under the auspices of the Centre of Research Excellence in Discovering Indigenous Strategies to Improve Cancer Outcomes Via Engagement, Research Translation and Training (DISCOVER-TT CRE, funded by the National Health and Medical Research Council no. 1041111) and the Strategic Research Partnership to improve Cancer control for Indigenous Australians (STREP Ca-CIndA, funded through Cancer Council NSW (SRP 13-01) with supplementary funding from Cancer Council WA). The views expressed in this publication are those of the authors and do not necessarily reflect the views of the funding agencies.

Compliance with ethical standards

Conflict of interest

There is no conflict of interest. Authors have no financial relationship with the organizations that sponsored the research. PCV had full control of all primary data and agree to allow the journal to review our data if requested.

Ethical approval

Ethics approvals for the study were obtained from the Human Research Ethics Committees of the Darling Downs Hospital and Health Service, Menzies School of Research, and QIMR Berghofer Medical Research Institute.

Supplementary material

520_2019_4821_MOESM1_ESM.docx (40 kb)
ESM 1 (DOCX 39 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Patricia C. Valery
    • 1
    Email author
  • Christina M. Bernardes
    • 1
  • Audra de Witt
    • 2
    • 3
  • Jennifer Martin
    • 4
  • Euan Walpole
    • 5
  • Gail Garvey
    • 2
  • Daniel Williamson
    • 6
  • Judith Meiklejohn
    • 1
    • 7
  • Gunter Hartel
    • 1
  • Isanka U. Ratnasekera
    • 1
    • 8
  • Ross Bailie
    • 9
  1. 1.Population HealthQIMR Berghofer Medical Research InstituteBrisbaneAustralia
  2. 2.Menzies School of Health ResearchCharles Darwin UniversityDarwinAustralia
  3. 3.Queensland University of Technology, Faculty of Health, Translational Research InstituteBrisbaneAustralia
  4. 4.School of Medicine and Public HealthThe University of NewcastleCallaghanAustralia
  5. 5.Princess Alexandra HospitalWoolloongabbaAustralia
  6. 6.Aboriginal and Torres Strait Islander Health UnitQueensland HealthBrisbaneAustralia
  7. 7.Orange Sky AustraliaBrisbaneAustralia
  8. 8.School of MedicineThe University of QueenslandBrisbaneAustralia
  9. 9.University Centre for Rural HealthThe University of SydneyLismoreAustralia

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