评估患者在细胞再生手术和腹腔内热化疗中的体验和医疗利用率。

Adrian Siu, Daniel Steffens, Nabila Ansari, Sascha Karunaratne, Henna Solanki, Nima Ahmadi, Michael Solomon, Cherry Koh
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引用次数: 0

摘要

目标约有 30% 的澳大利亚人居住在农村社区,由于路途遥远,前往这些社区的医疗机构就医非常困难。这可能会导致医疗保健公平性的差异,从而增加不良健康后果、诊断延迟和生活质量下降的风险。在晚期癌症患者中,这些地理限制因素可能会更加严重,因为只有经过选择的、具有适当专业技术的中心才能提供治疗。因此,本研究旨在探讨患者居住地对细胞减灭术(CRS)和腹腔内热化疗(HIPEC)后的体验和医疗服务利用率的影响。方法回顾性研究对2017年至2022年期间阿尔弗雷德皇家王子医院的连续CRS和HIPEC患者进行了调查。根据邮编将患者分为大都市和地区两类。在多个时间点收集了人口统计学、经历和医疗保健使用数据。统计分析包括卡方检验和T检验。结果 在317名参与者中,228人(72%)来自大都市,89人(28%)来自地区。地区患者倾向于将其住院经历评为 "非常好"(P=0.016)。大都市患者更遵守手术随访规定(P=0.016)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluating patient experience and healthcare utilisation in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Objective Approximately 30% of Australians reside in rural communities, where accessing healthcare facilities can be challenging due to considerable distance. This can result in disparities in healthcare equity, subsequently increasing risk of adverse health outcomes, delayed diagnosis, and diminished quality of life. These geographical constraints may be exacerbated in advanced cancers for which treatment is available only at selected centres with appropriate expertise. The aim of this study was therefore to explore the impact of patient residence on experience and healthcare utilisation following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods A retrospective study examined consecutive CRS and HIPEC patients at Royal Prince Alfred hospital from 2017 to 2022. Patients were stratified as metropolitan and regional based on their postcode. Demographics, experiential, and healthcare utilisation data were collected at multiple time points. Statistical analysis included chi-squared and T -tests. Results Of the 317 participants, 228 (72%) were from metropolitan and 89 (28%) from regional areas. Regional patients tended to rate their hospital experience as 'very good' (P =0.016). Metropolitan patients were more compliant with surgical follow-up (P <0.001). No other differences were observed in patient characteristics, experience or healthcare utilisation. Conclusions The geographical location of patients undergoing CRS and HIPEC for peritoneal malignancies at a major tertiary referral centre did not significantly influence their experience or healthcare utilisation outcomes. Future studies should evaluate long-term healthcare service utilisation or the ramifications of reduced follow-up on recurrence and survival, which will contribute to a deeper understanding of resource allocation in metropolitan and regional Australia, and illuminate its impact on clinical outcomes.

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