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Research article
Accessibility of Cancer Treatment Services for Indigenous Australians in the Northern Territory: Perspectives of Patients and Care Providers
Kate M Anderson
Menzies School of Health Research
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1214-2001
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: The poorer cancer outcomes of Indigenous Australians in Australia’s Northern Territory (NT) compared with their non-Indigenous counterparts is partially due to diminished access to cancer treatment services (CTS). The accessibility of health care is a multidimensional construct, including physical, logistical, psychosocial and cultural dimensions. While previous research has identified specific areas of reduced access to CTS for Indigenous Australians, the higher burden of cancer borne by Indigenous Australians warrants a more comprehensive understanding of access to CTS in the NT.
Aim: The purpose of this study was to explore and map the accessibility of CTS for Indigenous Australians in the NT and to identify key access barriers.
Methods: This study employed a mixed-methods convergent design to explore and map the accessibility of one CTS (CTS-NT) that services a large number of Indigenous Australians in the NT. Patient and care provider views were included. Patient perspectives were obtained via secondary analysis of data from open- and closed-questions from 75 face-to-face interviews with Indigenous Australian adults attending the CTS-NT. Care provider perspectives were obtained via primary analysis of data from 29 face-to-face semi-structured interviews with care providers and staff working at CTS-NT. Data were analysed to identify issues of accessibility informed by Leveque and colleagues’ conceptual framework of access to health care, which comprises five dimensions of accessibility of the health service and the ability of Indigenous patients to interact with these dimensions to generate access. Applied thematic analysis was conducted on the qualitative data and descriptive analysis was conducted on the quantitative data.
Results: The analysis of the patient and care provider reports identified multiple access barriers across all five dimensions including: inadequate preparation of Indigenous cancer patients for treatment; delayed and complicated commencement of treatment; dislocation from home; competing priorities; a scarcity of Indigenous care providers and staff; a lack of culturally-relevant care; challenges associated with language, accommodation, transport and finance; and disjointed and fraught relationships with care providers. These barriers posed significant challenges to Indigenous patients maintaining their engagement with treatment.
Conclusions: This study provides a valuable snapshot of the barriers facing this population across the five dimensions of health care access. Urgent action in addressing these issues is required at individual, service and state levels.
Keywords
Cancer, Aboriginal and Torres Strait Islander Australians, Cancer treatment, Health Services, Access, Equity, Patient-centred care
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On 16 Dec, 2020
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On 17 Nov, 2020
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On 16 Nov, 2020
Reviewer #1 agreed
On 16 Nov, 2020
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Accessibility of Cancer Treatment Services for Indigenous Australians in the Northern Territory: Perspectives of Patients and Care Providers
Kate M Anderson
Menzies School of Health Research
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1214-2001
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version (no preprint)
Posted 22 Dec, 2020
Editor assigned
On 22 Dec, 2020
Submission checks complete
On 22 Dec, 2020
Editor invited
On 22 Dec, 2020
This version was not preprinted
Version 1
Posted 21 Sep, 2020
No community comments so far
Editorial decision: Minor revision
On 16 Dec, 2020
Review #1 received
Received 18 Nov, 2020
Review #2 received
Received 18 Nov, 2020
Reviewer #3 agreed
On 17 Nov, 2020
Reviewer #2 agreed
On 16 Nov, 2020
Reviewer #1 agreed
On 16 Nov, 2020
Editor assigned
On 10 Sep, 2020
Reviewers invited
Invitations sent on 10 Sep, 2020
Submission checks complete
On 09 Sep, 2020
Editor invited
On 09 Sep, 2020
Version (no preprint)
Posted 07 Aug, 2020
This version was not preprinted
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The poorer cancer outcomes of Indigenous Australians in Australia’s Northern Territory (NT) compared with their non-Indigenous counterparts is partially due to diminished access to cancer treatment services (CTS). The accessibility of health care is a multidimensional construct, including physical, logistical, psychosocial and cultural dimensions. While previous research has identified specific areas of reduced access to CTS for Indigenous Australians, the higher burden of cancer borne by Indigenous Australians warrants a more comprehensive understanding of access to CTS in the NT.
Aim: The purpose of this study was to explore and map the accessibility of CTS for Indigenous Australians in the NT and to identify key access barriers.
Methods: This study employed a mixed-methods convergent design to explore and map the accessibility of one CTS (CTS-NT) that services a large number of Indigenous Australians in the NT. Patient and care provider views were included. Patient perspectives were obtained via secondary analysis of data from open- and closed-questions from 75 face-to-face interviews with Indigenous Australian adults attending the CTS-NT. Care provider perspectives were obtained via primary analysis of data from 29 face-to-face semi-structured interviews with care providers and staff working at CTS-NT. Data were analysed to identify issues of accessibility informed by Leveque and colleagues’ conceptual framework of access to health care, which comprises five dimensions of accessibility of the health service and the ability of Indigenous patients to interact with these dimensions to generate access. Applied thematic analysis was conducted on the qualitative data and descriptive analysis was conducted on the quantitative data.
Results: The analysis of the patient and care provider reports identified multiple access barriers across all five dimensions including: inadequate preparation of Indigenous cancer patients for treatment; delayed and complicated commencement of treatment; dislocation from home; competing priorities; a scarcity of Indigenous care providers and staff; a lack of culturally-relevant care; challenges associated with language, accommodation, transport and finance; and disjointed and fraught relationships with care providers. These barriers posed significant challenges to Indigenous patients maintaining their engagement with treatment.
Conclusions: This study provides a valuable snapshot of the barriers facing this population across the five dimensions of health care access. Urgent action in addressing these issues is required at individual, service and state levels.
Figure 1