Do gastrointestinal cancer patients want to decide where they have tests and surgery? a questionnaire study of provider choice and information needs
Author(s)
Byrne, BE
Faiz, OD
Darzi, A
Vincent, CA
Type
Conference Paper
Abstract
Introduction Choice of provider has been an important strategy among policy makers over recent years, intended, in part, to drive improvements in quality and efficiency of health care. Provider choice has been relatively under-studied among patients with cancer, compared with benign disease. This study examines decision-making experiences, preferences and information needs among patients who have had surgery for gastrointestinal cancer.
Method This questionnaire study used the single-item Control Preferences Scale to determine patients’ experiences and preferences when being referred for tests, and choosing where to have surgery. Participants used a Likert scale to rate the importance of 23 information items covering a variety of structures, process and outcomes at hospital- and department-level. Participants were recruited by post and online.
Results 463 responses were included. Where indicated, 334 of 415 (80.5%) respondents had upper gastrointestinal cancer. Postal response rates were higher than online (47.2% vs 23.1%,p < 0.001). Patients reported very low levels of involvement in provider choice, with their doctor deciding where they underwent tests or surgery in 77.0% and 81.8% of cases, respectively. Over two-thirds of participants would have preferred greater involvement in provider choice. Information on how long cancer patients wait for treatment, annual operative volume and postoperative mortality rate, as well as retained foreign bodies and infection rates were considered very important.
Conclusion There is a substantial unmet desire for greater involvement in provider choice among gastrointestinal cancer patients. Participants in this study attached particular importance to surgery-specific information. Improving involvement and information provision will require a coordinated approach in both primary and secondary care. Greater involvement in decision-making may increase satisfaction and contribute to a greater sense of control among these patients.
Method This questionnaire study used the single-item Control Preferences Scale to determine patients’ experiences and preferences when being referred for tests, and choosing where to have surgery. Participants used a Likert scale to rate the importance of 23 information items covering a variety of structures, process and outcomes at hospital- and department-level. Participants were recruited by post and online.
Results 463 responses were included. Where indicated, 334 of 415 (80.5%) respondents had upper gastrointestinal cancer. Postal response rates were higher than online (47.2% vs 23.1%,p < 0.001). Patients reported very low levels of involvement in provider choice, with their doctor deciding where they underwent tests or surgery in 77.0% and 81.8% of cases, respectively. Over two-thirds of participants would have preferred greater involvement in provider choice. Information on how long cancer patients wait for treatment, annual operative volume and postoperative mortality rate, as well as retained foreign bodies and infection rates were considered very important.
Conclusion There is a substantial unmet desire for greater involvement in provider choice among gastrointestinal cancer patients. Participants in this study attached particular importance to surgery-specific information. Improving involvement and information provision will require a coordinated approach in both primary and secondary care. Greater involvement in decision-making may increase satisfaction and contribute to a greater sense of control among these patients.
Date Issued
2015-06-01
Date Acceptance
2015-06-01
Citation
GUT, 2015, 64 (Suppl 1), pp.A119-A120
ISSN
0017-5749
Publisher
BMJ PUBLISHING GROUP
Start Page
A119
End Page
A120
Journal / Book Title
GUT
Volume
64
Issue
Suppl 1
Copyright Statement
© 2015 the Authors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000361954000245&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Source
2nd Digestive-Disorders-Federation Conference
Subjects
Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Publication Status
Published
Start Date
2015-06-22
Finish Date
2015-06-25
Coverage Spatial
London, ENGLAND
Date Publish Online
2015-06-22