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Pre-referral general practitioner consultations and subsequent experience of cancer care: evidence from the English Cancer Patient Experience Survey.


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Authors

Mendonca, SC 
Abel, GA 
Saunders, CL 
Wardle, J 
Lyratzopoulos, Georgios  ORCID logo  https://orcid.org/0000-0002-2873-7421

Abstract

Prolonged diagnostic intervals may negatively affect the patient experience of subsequent cancer care, but evidence about this assertion is sparse. We analysed data from 73 462 respondents to two English Cancer Patient Experience Surveys to examine whether patients with three or more (3+) pre-referral consultations were more likely to report negative experiences of subsequent care compared with patients with one or two consultations in respect of 12 a priori selected survey questions. For each of 12 experience items, logistic regression models were used, adjusting for prior consultation category, cancer site, socio-demographic case-mix and response tendency (to capture potential variation in critical response tendencies between individuals). There was strong evidence (P < 0.01 for all) that patients with 3+ pre-referral consultations reported worse care experience for 10/12 questions, with adjusted odds ratios compared with patients with 1-2 consultations ranging from 1.10 (95% confidence intervals 1.03-1.17) to 1.68 (1.60-1.77), or between +1.8% and +10.6% greater percentage reporting a negative experience. Associations were stronger for processes involving primary as opposed to hospital care; and for evaluation than report items. Considering 1, 2, 3-4 and '5+' pre-referral consultations separately a 'dose-response' relationship was apparent. We conclude that there is a negative association between multiple pre-diagnostic consultations with a general practitioner and the experience of subsequent cancer care.

Description

Keywords

cancer, consultation, general practitioner, oncology, patient experience, referral, Adult, Aged, England, Female, General Practice, Humans, Male, Middle Aged, Neoplasms, Patient Acceptance of Health Care, Patient Participation, Patient Satisfaction, Physician-Patient Relations, Referral and Consultation, Surveys and Questionnaires, Trust

Journal Title

Eur J Cancer Care (Engl)

Conference Name

Journal ISSN

0961-5423
1365-2354

Volume Title

Publisher

Hindawi Limited
Sponsorship
National Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough Clinical Commissioning Group (CCG)) (unknown)
GL is supported by a Cancer Research UK Clinician Scientist Fellowship (A18180). JW is supported by Cancer Research UK Programme Grant C1418/A14134.