Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?

Intern Med J. 2020 Jan;50(1):38-47. doi: 10.1111/imj.14356.

Abstract

Background: Cancer care involves many different healthcare providers. Delayed or inaccurate communication between specialists and general practitioners (GP) may negatively affect care.

Aim: To describe the pattern and variation of communication between primary healthcare (PHC) services and hospitals and specialists in relation to the patient's cancer care.

Methods: A retrospective audit of clinical records of Indigenous Australians diagnosed with cancer during 2010-2016 identified through 10 PHC services in Queensland is described. Poisson regression was used to model the dichotomous outcome availability of hospital discharge summary versus not.

Results: A total of 138 patient records was audited; 115 of those patients visited the PHC service for cancer-related care after cancer diagnosis; 40.0% visited the service before a discharge summary was available, and 36.5% of the patients had no discharge summary in their medical notes. While most discharge summaries noted important information about the patient's cancer, 42.4% lacked details regarding the discharge medications regimen.

Conclusions: Deficits in communication and information transfer between specialists and GP may adversely affect patient care. Indigenous Australians are a relatively disadvantaged group that experience poor health outcomes and relatively poor access to care. The low proportion of discharge summaries noting discharge medication regimen is of concern among Indigenous Australians with cancer who have high comorbidity burden and low health literacy. Our findings provide an insight into some of the factors associated with quality of cancer care, and may provide guidance for focus areas for further research and improvement efforts.

Keywords: Indigenous Australian; cancer care; communication; primary care.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • General Practitioners / standards
  • General Practitioners / statistics & numerical data
  • Health Services Accessibility / standards
  • Health Services Accessibility / statistics & numerical data
  • Health Services, Indigenous / standards
  • Health Services, Indigenous / statistics & numerical data*
  • Humans
  • Male
  • Medical Audit
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander / statistics & numerical data*
  • Neoplasms / ethnology
  • Neoplasms / therapy*
  • Physicians, Primary Care / statistics & numerical data*
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data
  • Primary Health Care / standards
  • Primary Health Care / statistics & numerical data*
  • Queensland / epidemiology
  • Referral and Consultation / standards
  • Referral and Consultation / statistics & numerical data*
  • Regression Analysis
  • Retrospective Studies
  • Young Adult