ISQua's 39th International Conference 2023

CANCER PATIENT DIAGNOSIS EXPERIENCE AND CARE QUALITY

Syeda OWAIS1, Gaston ARNOLDA1, Klay LAMPRELL1, Romika PATEL1, Jeffrey BRAITHWAITE1

1Australian Institute of Health Innovation , Macquarie University, Sydney, Australia

INTRODUCTION

•Patient experience is central to quality, alongside safety and care effectiveness.[1] Cancer Patient Experience Surveys (CPESs) conducted in England since 2010.

•Methodologically, three approaches have been proposed to assess patient satisfaction: 1) a global measure; 2) a measure for each aspect of care; and 3) a composite derived from (2).[2]

•Having needs met in the early stages of the cancer journey are important to satisfaction.[3]

AIM: To explore the relationship between diagnosis-related experiences and overall care rating for colorectal cancer patients in England, in 2018.

METHODS

Outcome: Overall care rating [‘Negative’ = Score < 8/10]

Predictors:

•Primary analysis: 6 questions about diagnostic experiences

•Secondary analysis: 3 additional questions

•NHS defined responses: Non-informative / Negative / Positive

DIAGNOSIS-RELATED QUESTIONS

[Question numbers as per CPES 2018]

Primary

Q1. Number of pre-referral GP visits

Q5. Enough information about test

Q7. Understood explanation of test result

Q8. Told could bring support person to cancer revelation

Q10. Understood explanation of the diagnosis

Q11. Received information about your cancer

Secondary [additional]

Q2. Feel about wait for referral

Q6. Feel about wait for test

Q9. Feel about way told about cancer

ANALYSIS:

•Logistic regression

•Models control for potential confounding by:

‒Age-group (<55, 55-64, 65-74, 75+)

‒Sex

‒Ethnic group (white British vs other)

•Individual questions retained as predictors in multivariable model if p<0.05 for BOTH:

‒The question was a predictor overall; and

‒% Negative vs % Positive was a predictor

RESULTS

Percent with negative experiences

•4% have insufficient information about their test;

•18-22% have -ve experiences for other questions

ORs of -ve experiences as predictors of –ve care rating

•All six experiences significant (OR range: 1.64-3.50)

Composite rating

•Those with no negative experiences have 4% poor overall rating vs 86% for those with all six

Secondary analysis

•Adding three ‘feelings’ question showed similar results, with 8 of 9 questions significant predictors;

-‘Feel about wait for test’ (OR=2.0) replaced ‘No. GP visits’

-‘Feel about wait for test’ & ‘Feel about way told about cancer’ both independent predictors (ORs 1.9 & 1.6)

CONCLUSIONS

•For CRC patients, after controlling for age and gender all -ve diagnosis related experiences are important

-Prioritise what is easiest to improve

•Ideally, RCTs of interventions to reduce rates of negative experiences

-Compare rates of (1) -ve experiences; and (2) poor overall ratings of care

Limitations:

1. Self-selected respondents (64% response rate overall)

2. Ethnicity very broad categorisation. No data on socio-economic status or cancer stage

REFERENCES:

1. Darzi, A., High quality care for all: NHS Next Stage Review final report, 2008, in London: Department of Health. 2008.

2. Locker, D. and D. Dunt, Theoretical and methodological issues in sociological studies of consumer satisfaction with medical care. Social Science & Medicine, 1978. 12: p. 283-292.

3. Tran, Y., et al., What information do patients want across their cancer journeys? A network analysis of cancer patients’ information needs. Cancer Medicine, 2019. 8(1): p. 155-164.

ISQua's 39th International Conference 2023

CANCER PATIENT DIAGNOSIS EXPERIENCE AND CARE QUALITY

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