Evaluating patient experience and healthcare utilisation in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
Adrian Siu A B * , Daniel Steffens
A B , Nabila Ansari A C , Sascha Karunaratne A B , Henna Solanki A , Nima Ahmadi A C , Michael Solomon A B C and Cherry Koh A B C
A
B
C
Abstract
Approximately 30% of Australians reside in rural communities, where accessing healthcare facilities can be challenging due to considerable distance. This can result in disparities in healthcare equity, subsequently increasing risk of adverse health outcomes, delayed diagnosis, and diminished quality of life. These geographical constraints may be exacerbated in advanced cancers for which treatment is available only at selected centres with appropriate expertise. The aim of this study was therefore to explore the impact of patient residence on experience and healthcare utilisation following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
A retrospective study examined consecutive CRS and HIPEC patients at Royal Prince Alfred hospital from 2017 to 2022. Patients were stratified as metropolitan and regional based on their postcode. Demographics, experiential, and healthcare utilisation data were collected at multiple time points. Statistical analysis included chi-squared and T-tests.
Of the 317 participants, 228 (72%) were from metropolitan and 89 (28%) from regional areas. Regional patients tended to rate their hospital experience as ‘very good’ (P = 0.016). Metropolitan patients were more compliant with surgical follow-up (P < 0.001). No other differences were observed in patient characteristics, experience or healthcare utilisation.
The geographical location of patients undergoing CRS and HIPEC for peritoneal malignancies at a major tertiary referral centre did not significantly influence their experience or healthcare utilisation outcomes. Future studies should evaluate long-term healthcare service utilisation or the ramifications of reduced follow-up on recurrence and survival, which will contribute to a deeper understanding of resource allocation in metropolitan and regional Australia, and illuminate its impact on clinical outcomes.
Keywords: cytoreductive surgery, geographic disparity, healthcare equity, healthcare utilisation, hyperthermic intraperitoneal chemotherapy, patient experience, peritoneal malignancies, surgical oncology.
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