Patterns and Predictors of Colorectal Cancer Care Coordination: A Population-Based Survey of Australian Patients

摘要

BACKGROUND: Improving care coordination is a key priority for health services. The aims of this study were to identify patient-and health service-related predictors of poorly coordinated care and to explore patient preferences to assist care coordination. METHODS: Patients with incident colorectal cancer, identified from a state-wide cancer registry, completed a self-report questionnaire 6 to 8 months after their diagnosis. Care coordination was assessed with the Cancer Care Coordination Questionnaire for Patients. Multiple linear regression models were used to predict factors associated with a poor experience with cancer care coordination. RESULTS: Among 560 patients (56% response rate), care coordination experiences were normally distributed (mean score, 76.1; standard deviation, 10.9). Patients who had 3 or more comorbid conditions (beta, -4.56; standard error [SE], 1.46; P=.006), little or no understanding of the health system (beta, -4.34; SE, 0.94; P<.001), and no regular general practitioner (GP; beta, -4.09; SE, 2.07; P=.049) experienced poorer care coordination. At the health service level, patients who did not receive a written pretreatment plan (beta, -4.15; SE, 0.95; P<.001) or did not see a cancer care coordinator (beta, -3.29; SE, 1.03; P=.001) had lower scores. The most preferred resources included information packs (92%), written care plans (88%), and improved access to their own personal medical records (electronic, 86; paper, 84%), with most patients preferring a shared GP and surgeon care model. CONCLUSIONS: There was wide variation in experiences across the state. The factors associated with lower scores provide a focus for targeted strategies for improving patients' experience with colorectal cancer care coordination. (C) 2016 American Cancer Society.