Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia.
J Eval Clin Pract. 2023 Dec;29(8):1302-1313. doi: 10.1111/jep.13918. Epub 2023 Aug 22.
Head and neck surgery services are increasingly being centralised in Australia. Outreach models can overcome burdens of travel that patients in regional and rural areas experience when attending routine appointments, by providing services closer to home.
To explore patient-reported experiences and satisfaction with regional outreach services for head and neck surgery in Australia.
Patients who attended two regional outreach clinics in New South Wales (NSW), Australia, were surveyed over a 6-month period. Patients completed the Outpatient Cancer Clinics Survey (2020 version) that explored perceptions and experiences of the clinic. Patients with cancer were asked to complete the Edmonton Symptom Assessment System and the Communication and Attitudinal Self-Efficacy scale. Descriptive statistics and analysis of data was performed, and results were compared to the NSW statewide Outpatient Cancer Clinics Survey (2020). Content analysis of free text responses was performed.
Some 128 patients responded (56% response rate; mean age 67.2 years, 46.1% female). Compared to the 2020 NSW survey, a higher proportion of patients in our cohort responded positively to 14 of the 26 questions, with the greatest differences observed for questions regarding waiting area comfort (+12.1%, p = 0.008), being informed about different treatment options (+9.5%, p = 0.04), and issues relating to parking (+9.5%, p = 0.03). A lower proportion of our sample responded positively to the question about whether health professionals knew enough about their medical history (-19.3%, p < 0.001). Respondents appreciated having a local clinic that helped them avoid travel to major cities and associated expenses and highlighted benefits of expert consultation and timeliness of investigations. However, cost of appointments and level of reimbursements remain barriers for some patients.
Patients had a high level of satisfaction with regional outreach clinics for head and neck surgery across most domains, indicating patients highly value this service.
头颈部外科手术服务在澳大利亚日益集中。拓展服务模式可以通过在离家更近的地方提供服务，克服患者在区域和农村地区常规就诊时面临的旅行负担。
探讨澳大利亚头颈部外科手术区域拓展服务的患者报告体验和满意度。
在澳大利亚新南威尔士州（新州）的两个区域拓展诊所就诊的患者在 6 个月期间接受了调查。患者完成了门诊癌症诊所调查（2020 年版），以探讨他们对诊所的看法和体验。癌症患者被要求完成埃德蒙顿症状评估系统和沟通与态度自我效能量表。对数据进行描述性统计和分析，并将结果与新州全州门诊癌症诊所调查（2020 年版）进行比较。对自由文本回复进行内容分析。
共有 128 名患者做出回应（回应率为 56%；平均年龄 67.2 岁，46.1%为女性）。与 2020 年新州调查相比，我们的研究对象对 26 个问题中的 14 个问题的积极回应比例更高，其中在等候区舒适度（+12.1%，p=0.008）、了解不同治疗方案（+9.5%，p=0.04）和与停车相关的问题（+9.5%，p=0.03）方面的差异最大。我们的样本中，对医疗专业人员是否足够了解他们的病史的问题做出积极回应的比例较低（-19.3%，p<0.001）。受访者赞赏当地诊所，因为它帮助他们避免前往主要城市和相关费用，并强调专家咨询和调查及时性的好处。然而，预约费用和报销水平仍是一些患者的障碍。
在大多数领域，患者对头颈部外科手术区域拓展诊所的满意度较高，这表明患者非常重视这项服务。
