Aims

Survival rates for patients with cancer who live in rural and regional areas are poorer compared to metropolitan areas. This may be due to geographical isolation, delayed diagnosis, inadequate transport, lower socio-economic status, and workforce shortages. We conducted a qualitative study of rural patients, carers and health professionals. It aimed to identify concerns about, and strategies to optimise cancer care from those with direct experience.

Methods

Focus groups and structured interviews were conducted in NSW, Australia at four rural/regional hospitals (Bega, Dubbo, Tamworth and Albury), and 3 metropolitan locations (RPAH, POWH, and the Jean Colvin Hostel) caring for rural patients. Sessions were audiotaped, transcribed and analysed using thematic analysis.

Results

36 patients, 14 carers and 32 health professionals were interviewed in 7 focus groups and 42 individual interviews. Concerns related to access to oncologists and other health professionals, and for services for investigation and treatment, the financial and social consequences of travel, unmet carer support needs, and the hardships for health professionals. Strategies for improvement included comprehensive staffing and services coordinated in a hub and spoke model from adjacent larger centres, adequate reimbursement for travel, and better carer support.

Conclusions

We identified broad concerns about regional and rural cancer care in Australia. The Australian Federal Government commitment of $560 million to establish regional cancer centres is welcome, however improvements must extend beyond infrastructure funding in large regional centres to comprehensive staffing in centres currently lacking resident oncologists, travel support, and assistance for carers.