Timeliness of cancer care in a regional Victorian health service: A comparison of high‐volume (Lung) and low‐volume (oesophagogastric) tumour streams

Abstract

Background Timeliness of cancer care is vital for improved survival and quality of life of patients. Service and care centralisation at larger‐volume centres has been associated with improved outcomes. However, there is a lack of systematic data on the impact of tumour stream volume on timeliness of care. Aims To investigate and compare timeliness of care for lung cancer, a high‐volume (more commonly diagnosed) tumour stream, and oesophagogastric (OG) cancer, a low‐volume (less commonly diagnosed) tumour stream, at a regional health service in Victoria, Australia. Methods A retrospective cohort study comprising random samples of 75 people newly diagnosed with lung cancer (International Classification of Diseases and Related Health Problems‐10 [ICD‐10] diagnosis codes C34 in the Victorian Cancer Registry [VCR]) and 50 people newly diagnosed with OG cancer (ICD‐10 diagnosis codes C15 or C16 in VCR) at one regional Victorian health service between 2016 and 2017. Binary logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between patient factors and suboptimal timeliness of care. Results In comparison to OG cancer patients, lung cancer patients had reduced odds of suboptimal timeliness of care in reference to times outside OCP for referral to diagnosis (OR [95% CI] = 0.34 [0.14 to 0.83]) but increased odds of suboptimal timeliness for diagnosis to treatment (OR [95% CI] = 2.48 [1.01 to 6.09]). Conclusion In the low‐volume OG cancer stream, patients had longer wait times from referral to an MDM, where treatment decisions occur, but shorter time to commencement of first treatment. Conversely in the high‐volume lung cancer group, there was delayed initiation of first treatment following presentation at MDM. There is need to explore ways to fast‐track MDM presentation and commencement of therapy among people diagnosed with low‐volume and high‐volume cancers, respectively.

New approach to implement cancer patient care: The valutazione percorso rete oncologica campana (ValPeROC)‐experience from an Italian oncology network

“…This experience will produce knowledge and data to guide decision-making and to manage more effectively the challenges of fighting cancer in Campania region. In this context, delays in cancer diagnosis and treatment (Kabwe et al, 2021) and poor cancer care coordination between health professionals and health-care fragmentation represent the most important challenges to face: Cancer treatment requires multimodal therapies, treatment of any associated comorbidity and multiple organisational levels, health services, providers and sites of care. Therefore, a closer cancer care coordination and the implementation of a more integrated and continuous health-care system represent key objectives to be achieved, in order to reduce delays, medical errors and health-care costs (Gorin et al, 2017).…”

Implementing Optimal Care Pathways for Aboriginal and Torres Strait Islander People With Cancer: A Survey of Rural Health Professionals’ Self-Rated Learning Needs

“…While the OCP has been nationally endorsed, its implementation relies on the capacity of health services and practitioners to incorporate it into clinical practice. To date, implementation of tumour-specific OCPs in Australia has focussed on clinical audits of operational, diagnostic and referral processes as outcome measures [20][21][22]. Cultural and psychosocial elements may not be readily documented in clinical notes or have defined or standardised categories for measurement.…”