Carruthers Scott, Pennefather Mary, Ward Linda, Giam Kar, Penniment Michael
Alan Walker Cancer Care Centre, Royal Darwin Hospital, Tiwi, Northern Territory, Australia.
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
J Med Imaging Radiat Oncol. 2019 Aug;63(4):510-516. doi: 10.1111/1754-9485.12887. Epub 2019 May 13.
Barriers exist for both Indigenous and remote patients attending cancer care facilities. We sought to measure clinical attendance of all patients referred for consideration of radiation therapy (RT) at the single radiation therapy centre in the Northern Territory (NT), with particular attention to a comparison of Indigenous and non-Indigenous patients, and to analyse methods introduced to address the attendance of patients.
Patients referred for radiation therapy over a 5 year period from the commencement of the Alan Walker Cancer Care Centre (AWCCC), NT, were analysed for attendance, and for possible improvement over time.
Multivariate analysis of non-attendance prior to RT (pre-RT) showed significance for Indigenous status (P < 0.001), and female gender (P < 0.001), and during RT showed significance for Indigenous status (P < 0.001) and curative intent RT (P = 0.012). Attendance during RT over the 5 years showed significant improvement over time for Indigenous patients from 70.6% to 81.6% (P = 0.038). There was no significant improvement with pre-RT attendance for either the Indigenous or non-Indigenous cohort.
Indigenous patients experienced a lower level of attendance during RT, but this has significantly improved over the first 5 years of operation at AWCCC, as recognition and management of contributing factors has improved.
原住民和偏远地区的患者在前往癌症护理机构就医时存在诸多障碍。我们试图衡量在北领地（NT）唯一的放射治疗中心所有被转诊考虑接受放射治疗（RT）的患者的临床就诊情况，特别关注原住民和非原住民患者的比较，并分析为解决患者就诊问题而采用的方法。
对从北领地艾伦·沃克癌症护理中心（AWCCC）开业起的5年期间被转诊接受放射治疗的患者的就诊情况以及随时间可能的改善情况进行分析。
对放疗前（RT前）未就诊情况的多变量分析显示，原住民身份（P < 0.001）和女性性别（P < 0.001）具有显著意义，而在放疗期间，原住民身份（P < 0.001）和根治性放疗意图（P = 0.012）具有显著意义。5年期间放疗期间的就诊情况显示，原住民患者随时间有显著改善，从70.6%提高到81.6%（P = 0.038）。原住民或非原住民队列在放疗前的就诊情况均无显著改善。
原住民患者在放疗期间的就诊率较低，但在AWCCC运营的前5年中，随着对影响因素的认识和管理得到改善，这一情况有了显著改善。
