Dataset Information

Coverage of cancer services in Australia and providers' views on service gaps: findings from a national cross-sectional survey.

ABSTRACT:

Background

In response to the increasing cancer prevalence and the evolving health service landscape across the public and private health sectors in Australia, this study aimed to map cancer services and identify factors associated with service provision and important service gaps.

Methods

A prospective, cross-sectional survey was conducted throughout 2016. Extensive search strategies identified Government or privately-owned, hospital or community-based healthcare organisations with dedicated cancer services. One nominated staff member from each organisation answered a purpose specific online/paper questionnaire. Descriptive statistics, standardised rates, and single level and multilevel multinomial logistic regression were used to analyse the data. Analysis was augmented with a qualitative descriptive analysis of open-ended questions.

Results

From the 295 eligible organisations with a cancer service in Australia, 93.2% participated in the survey. After adjusting for remoteness, for-profit companies were significantly more likely than Government operated services to provide only one or two types of cancer services (e.g. radiotherapy) in a limited range of settings (e.g. day hospital with no in-patient or home care) (p?ConclusionsThe broad range of cancer services, settings and ownership identified by this survey highlights the complexity of the Australian healthcare system that cancer survivors must navigate and the challenges of providing comprehensive cancer care particularly in rural and remote regions. Whilst the significant role of supportive care and survivorship services are increasingly being recognised, the findings from this survey support calls for innovative service models and funding mechanisms that expand the focus from preventing and treating cancer to supporting cancer survivors throughout the cancer continuum and promoting the delivery of integrated and equitable cancer care across the public and private sectors.

SUBMITTER: Hunter J

PROVIDER: S-EPMC6560726 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

Coverage of cancer services in Australia and providers' views on service gaps: findings from a national cross-sectional survey.

Hunter Jennifer J Smith Caroline C Delaney Geoff P GP Templeman Kate K Grant Suzanne S Ussher Jane M JM

BMC cancer 20190611 1

<h4>Background</h4>In response to the increasing cancer prevalence and the evolving health service landscape across the public and private health sectors in Australia, this study aimed to map cancer services and identify factors associated with service provision and important service gaps.<h4>Methods</h4>A prospective, cross-sectional survey was conducted throughout 2016. Extensive search strategies identified Government or privately-owned, hospital or community-based healthcare organisations wi ...[more]

PMID: 31185937

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Project description:BackgroundIndividuals living with and beyond a cancer diagnosis are increasingly using complementary therapies and medicines (CM) to enhance the effectiveness of cancer treatment, manage treatment-related side effects, improve quality-of-life, and promote self-efficacy. In response to the increasing use and demand for CM by cancer patients, interest in the implementation of Integrative Oncology (IO) services that provide CM alongside conventional cancer care in Australia and abroad has developed. The extent that cancer services in Australia are integrating CM is uncertain. Thus, the aim of this study was to identify IO services in Australia and explore barriers and facilitators to IO service provision.MethodsA national, cross-sectional survey of healthcare organisations was conducted in 2016. Organisations in the public and private sectors, including not-for-profit organisations that provided cancer care in hospital or community setting, were included.ResultsA response rate of 93.2% was achieved (n = 275/295). Seventy-one organisations (25.8%) across all states/territories, except the Northern Territory, offered IO albeit in a limited amount by many. Most common IO services included massage, psychological-wellbeing, and movement modalities in hospital outpatient or inpatient settings. There were only a few instances where biological-based complementary medicine (CM) therapies were prescribed. Funding was often mixed, including patient contributions, philanthropy, funding by the organisation, and volunteer practitioners. Of the 204 non-IO providers, 80.9% had never provided any IO service. Overwhelmingly, the most common barrier to IO was a lack of funding, followed by uncertainty about patient demand, choice of services, and establishing such services. Less-common barriers were a lack of evidence, and support from oncologists or management. More funding, education and training, and building the evidence-base for CM were the most commonly suggested solutions.ConclusionIO is increasingly being provided in Australia, although service provision remains limited or non-existent in many areas. Mismatches appear to exist between low IO service provision, CM evidence, and high CM use by cancer patients. Greater strategic planning and policy guidance is indicated to ensure the appropriate provision of, and equitable access to IO services for all Australian cancer survivors.

Project description:BackgroundHigh levels of aggression towards staff in healthcare settings have been reported. It seems likely that workers in Opioid Substitution Therapy (OST) would be at increased risk of adverse events and their consequences.ObjectivesThis study aimed to establish if practitioners who provide OST are experiencing negative outcomes, specifically aggression, distress, and burnout, and to identify if workload and professional affiliation were associated with these risks.MethodsA survey was conducted of OST practitioners in a single geographical region of New Zealand (population approx. 344,000). The survey asked for demographics (including caseloads), Perception of Patient Aggression Scale New Zealand Revision (POPAS-NZ), Kessler 10 (K10), Short Post-Traumatic Stress Disorder Rating Interview (SPRINT), and Abbreviated Maslach Burnout Inventory (aMBI) and two qualitative questions asking about the best and worst aspects of working in OST.ResultsAll recorded OST workers in the region (n = 181) were invited to participate, 95 practitioners responded to the survey (52.4%). This group included pharmacists, doctors, nurses, social workers and addiction workers. Results indicated aggression, distress, and burnout were being experienced by practitioners. Number of patients seen by a practitioner significantly increased risk of aggression (F(1,90) = 14.14, p < 0.001). Psychiatrists were the most at risk profession (p = 0.016). Burnout responses were high for around 20% of practitioners, with low numbers meeting criteria for distress and PTSD. Positive things about working in OST were relationships with patients, appreciating patient outcomes and positive team environments. Negative aspects were patient behaviours, maintaining empathy, and, administration tasks.ConclusionsAggression was a workplace hazard for OST clinicians. Low rates of distress and PTSD symptoms were reported and some evidence of practitioner burnout. Practitioners reported positive relationships, making a difference and teamwork may have been improving this area of mental health work.

Project description:ObjectivesTo estimate the prevalence in Australia of each type of child maltreatment; to identify gender- and age group-related differences in prevalence.Design, settingCross-sectional national survey; mobile telephone interviews using random digit dialling (computer-generated), Australia, 9 April - 11 October 2021. Retrospective self-report data using validated questionnaire (Juvenile Victimisation Questionnaire-R2 Adapted Version (Australian Child Maltreatment Study).ParticipantsPeople aged 16 years or more. The target sample size was 8500 respondents: 3500 people aged 16-24 years and 1000 respondents each from five further age groups (25-34, 35-44, 45-54, 55-64, 65 years or more).Main outcome measuresProportions of respondents reporting physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence to age 18 years, assessed with the Juvenile Victimization Questionnaire-R2 Adapted Version (Australian Child Maltreatment Study), overall and by gender and age group, and weighted to reflect characteristics of the Australian population aged 16 years or more in 2016.ResultsComplete survey data were available for 8503 eligible participants (14% response rate). Physical abuse was reported by 32.0% of respondents (95% confidence interval [CI], 30.7-33.3%), sexual abuse by 28.5% (95% CI, 27.3-29.8%), emotional abuse by 30.9% (95% CI, 29.7-32.2%), neglect by 8.9% (95% CI, 8.1-9.7%), and exposure to domestic violence by 39.6% (95% CI, 38.3-40.9%). The proportions of respondents who reported sexual abuse, emotional abuse, or neglect were each statistically significantly larger for women than men. The reported prevalence of physical abuse by respondents aged 16-24 years was lower than for those aged 25-34 years, and that of sexual abuse was lower than for those aged 35-44 years, suggesting recent declines in the prevalence of these maltreatment types.ConclusionsChild maltreatment is common in Australia, and larger proportions of women than men report having experienced sexual abuse, emotional abuse, and neglect during childhood. As physical and sexual abuse may have declined recently, public health policy and practice may have positive effects, justifying continued monitoring and prevention activities.

Project description:BackgroundThere is a need to improve retention and outcomes for treatment of problem gambling and gambling disorder. Contingency management (CM) is a behavioural intervention involving identification of target behaviours (such as attendance, abstinence, or steps towards recovery) and the provision of incentives (such as vouchers or credits towards the purchase of preferred items) contingent on objective evidence of these behaviours. Contingency management for abstinence and attendance in substance misuse treatment has a substantial evidence base but has not been widely adopted or extended to other addictive behaviours such as gambling. Potential barriers to the widespread adoption of CM may relate to practitioners' perceptions about this form of incentive-based treatment. The present study sought to explore United Kingdom (UK) gambling treatment providers' views of CM for treatment of problem gambling and gambling disorder.MethodsWe conducted semi-structured interviews with 30 treatment providers from across the UK working with people with gambling problems. Participants were provided with an explanation of CM, several hypothetical scenarios, and a structured questionnaire to facilitate discussion. Thematic analysis was used to interpret findings.ResultsParticipants felt there could be a conflict between CM and their treatment philosophies, that CM was similar in some ways to gambling, and that the CM approach could be manipulated and reduce trust between client and therapist. Some participants were more supportive of implementing CM for specific treatment goals than others, such as for incentivising attendance over abstinence due to perceived difficulties in objectively verifying abstinence. Participants favoured providing credits accruing to services relevant to personal recovery rather than voucher-based incentives.ConclusionsUK gambling treatment providers are somewhat receptive to CM approaches for treatment of problem gambling and gambling disorder. Potential barriers and obstacles are readily addressable, and more research is needed on the efficacy and effectiveness of CM for gambling.

Project description:The purpose of the study is to provide estimates for immunization coverage, considering single-dose and schemes (three or five vaccines), by comparing self-report method to immunization cards, while also assessing the timeliness of immunization in Mexico, with reference to Mexican Immunization Program guidelines. Data on immunization was obtained from the Mexican Immunization Survey conducted in 2017 that aimed to assess crude (card-based) coverage at the regional level. Timely immunization was defined with reference to National Immunization Program guidelines, and immunization coverage was defined as a three or five vaccine scheme, based on previous national reports of immunization coverage. Immunization coverage estimates account for sample weights from the complex survey design. We used weighted immunization coverage estimates to assess the extent to which immunization cards and self-reporting concurred. It was found that most Mexican children are not receiving their full vaccine schedule in a timely manner. Concerning children under twelve months of age, the coverage targets for National Immunization of 95 % was not reached for either vaccine, and only 2.94 % (95 % CI 0.92-9.01) who had been receiving a three-vaccine scheme were considered as fully immunized in a timely manner. In contrast, coverage increased to 33.94 % (95 % CI 26.99-41.66), when untimely immunizations were taken into account, and the 95 % target was reached for five vaccines. Likewise, there is little correlation between self-report and immunization cards but rates show more concurrence, when only considering the proportion of true positives. In conclusion it was find that children at a local level are vaccinated in an incomplete and untimely manner. In order to improve immunization systems, a nominal registry of administered doses is thus of paramount importance. There is a need to address underlying health inequalities, as well as the factors associated with these, resulting in improved chances of a disease-free childhood and healthy life.

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Dataset Information

Coverage of cancer services in Australia and providers' views on service gaps: findings from a national cross-sectional survey.

Background

Methods

Results

Publications

Coverage of cancer services in Australia and providers' views on service gaps: findings from a national cross-sectional survey.

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