Patterns and predictors of colorectal cancer care coordination: A population-based survey of Australian patients
Durcinoska I, Young JM, Solomon MJ.
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.
Patients with incident colorectal cancer, identified from a state-wide cancer registry, completed a self-report questionnaire6 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.
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 (β, -4.56; standard error [SE], 1.46; P = .006), little or no understanding of the health system (β, -4.34; SE, 0.94; P < .001), and no regular general practitioner (GP; β, -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 (β, -4.15; SE, 0.95; P < .001) or did not see a cancer care coordinator (β, -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.
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.