Health Behaviour Research Group, Priority Research Centre for Health Behaviour, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia.
J Rural Health. 2013 Aug;29 Suppl 1:s43-50. doi: 10.1111/jrh.12020. Epub 2013 Mar 25.
Little is known about access to care for hematological cancer patients. This study explored patient experiences of barriers to accessing care and associated financial and social impacts of the disease. Metropolitan versus nonmetropolitan experiences were compared.
A state-based Australian cancer registry identified adult survivors of hematological cancers (including lymphoma, leukemia and myeloma) diagnosed in the previous 3 years. Survivors were mailed a self-report pen and paper survey.
Of the 732 eligible survivors, 268 (37%) completed a survey. Forty percent of participants reported at least one locational barrier which limited access to care. Only 2% reported cancer-related expenses had restricted their treatment choices. Almost two-thirds (64%) reported at least one financial or social impact on their daily lives related to cancer. The most frequently reported impacts were the need to take time off work (44%) and difficulty paying bills (21%). Survivors living in a nonmetropolitan location had 17 times the odds of reporting locational or financial barriers compared with those in metropolitan areas. Preferred potential solutions to alleviate the financial and social impacts of the disease were: free parking for tests or treatment (37%), free medications or treatments (29%), and being able to get treatment in their local region (20%).
Providing more equitable access to care for hematological cancer patients in Australia requires addressing distances traveled to attend treatment and their associated financial and social impacts on nonmetropolitan patients. Greater flexibility in service delivery is also needed for patients still in the workforce.
对于血液癌症患者的医疗服务获取途径，我们知之甚少。本研究旨在探讨患者在获得医疗服务方面所面临的障碍，以及疾病所带来的经济和社会影响。并对城市和非城市地区的体验进行了比较。
澳大利亚一个基于州的癌症登记处确定了在过去 3 年内被诊断患有血液癌（包括淋巴瘤、白血病和骨髓瘤）的成年幸存者。向幸存者邮寄了一份纸笔自我报告调查问卷。
在 732 名符合条件的幸存者中，有 268 名（37%）完成了调查。40%的参与者报告至少存在一处地理位置障碍，限制了他们获得医疗服务的机会。仅有 2%的人报告癌症相关费用限制了他们的治疗选择。近三分之二（64%）的人报告癌症对他们的日常生活至少有一个经济或社会影响。报告频率最高的影响是需要请假（44%）和难以支付账单（21%）。与居住在城市地区的幸存者相比，居住在非城市地区的幸存者报告存在地理位置或经济障碍的可能性高出 17 倍。缓解疾病经济和社会影响的潜在首选解决方案是：免费停车进行检查或治疗（37%）、免费药物或治疗（29%）以及能够在当地接受治疗（20%）。
为澳大利亚的血液癌症患者提供更公平的医疗服务获取途径，需要解决治疗过程中需要长途跋涉的问题，以及这对非城市地区患者带来的经济和社会影响。对于仍在工作中的患者，还需要提供更具弹性的服务交付方式。
