Uptake of Team Care Arrangements for adults newly diagnosed with cancer
Oscar Perez-Concha
A * , David Goldstein B , Mark F. Harris C , Maarit A. Laaksonen D , Mark Hanly A , Sue Suchy E and Claire M. Vajdic A
A Centre for Big Data Research in Health, UNSW Sydney, Sydney, NSW, Australia.
B Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia.
C Centre for Primary Health Care and Equity, UNSW Sydney, Sydney, NSW, Australia.
D School of Mathematics and Statistics, UNSW Sydney, Sydney, NSW, Australia.
E Consumer Advisory Panel, Translational Cancer Research Network, Sydney, NSW, Australia.
Australian Journal of Primary Health 29(1) 20-29 https://doi.org/10.1071/PY22078
Submitted: 14 April 2022 Accepted: 9 August 2022 Published: 9 September 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Medicare-subsidised Team Care Arrangements (TCAs) support Australian general practitioners to implement shared care between collaborating health professionals for patients with chronic medical conditions and complex needs. We assessed the prevalence of TCAs, factors associated with TCA uptake and visits to TCA-subsidised allied health practitioners, for adults newly diagnosed with cancer in New South Wales, Australia.
Methods: We carried out a retrospective individual patient data linkage study with 13 951 45 and Up Study participants diagnosed with incident cancer during 2006–16. We used a proportional hazards model to estimate the factors associated with receipt of a TCA after cancer diagnosis.
Results: In total, 6630 patients had a TCA plan initiated (47.5%). A TCA was more likely for patients aged ≥65 years, those with higher service utilisation 4–15 months prior to cancer diagnosis, a higher number of comorbidities, lower self-rated overall health status, living in areas of greater socio-economic disadvantage, lower educational attainment and those with no private health insurance. A total of 4084 (61.6%) patients with a TCA had at least one TCA-subsidised allied health visit within 24 months of the TCA.
Conclusions: TCAs appear to be well targeted at cancer patients with chronic health conditions and lower socioeconomic status. Nevertheless, not all patients with a TCA subsequently attended a TCA-subsidised allied healthcare professional. This suggests either a misunderstanding of the plan, the receipt of allied health via other public schemes, a low prioritisation of the plan compared to other health care, or suboptimal availability of these services.
Keywords: cancer patients, community health care, data linkage, health care utilisation, health services: accessibility, New South Wales, patient-centred care, Team Care Arrangements.
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