Patient Experience with Outpatient Cancer Care in British Columbia
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Patient Experiences with Outpatient Cancer Care in British Columbia, 2012/13 January 2014 Charlyn Black MD ScD Dawn Mooney MPH Sandra Peterson MSc Patient Experiences with Outpatient Cancer Care in British Columbia, 2012/13 was produced by: Centre for Health Services and Policy Research University of British Columbia 201–2206 East Mall Vancouver, BC V6T 1Z3 Phone: 604-822-4969 Email: [email protected] You can download this publication from www.chspr.ubc.ca U B C C entre for health servi C es and poli C y r e s e a r C h Contents 2 List of tables and figures 4 About CHSPR 5 Acknowledgments 6 Executive Summary 6 About this survey 6 Findings 7 Introduction 7 The importance of understanding patient experience 7 Approaches to understanding patient experience in BC 8 BC’s 2005/06 and 2012/13 outpatient cancer care surveys 10 The Canadian benchmarks 11 About this report 12 1. What did we learn? Findings from 2012/13 12 1.1 Characteristics of patients who responded to the survey 16 1.2 Overall evaluations of care 21 1.3 Evaluations of individual patient-centred dimensions of care 29 1.4 Areas of strength reported by BC patients 30 1.5 Areas for improvement reported by BC patients 31 2. How have patient experiences changed since 2005/06? 31 2.1 Approaches to comparing 2005/06 and 2012/13 survey responses 32 2.2 Overall evaluations of care, 2012/13 vs. 2005/06 33 2.3 Overall evaluations based on combined dimensions of care, 2012/13 vs. 2005/06 34 2.4 Dimension scores 2012/13 vs. 2005/06 35 2.5 Areas of strength, 2012/13 vs. 2005/06 36 2.5 Areas for improvement, 2012/13 vs. 2005/06 37 Discussion and conclusions 41 References 42 Appendix 1: Participating facilities by 2012/13 peer group 1 p a t i e n t e x p e r i e n C e s w i t h o U t p a t i e n t C a n C e r C a r e i n B r i t i s h C o l U m B ia, 2012/13 List of tables and figures 12 Table 1: Number and percent of respondents or patients, by age, sex, ethnicity, and type of cancer 13 Table 2: Number and percent of respondents or patients, by type and location of care 14 Figure 1: Health status among patients receiving outpatient cancer care in BC, 2012/13, compared to Canadian benchmark 14 Figure 2: Emotional health among patients receiving outpatient cancer care in BC, 2012/13 15 Figure 3: Amount of pain among patients receiving outpatient cancer care in BC, 2012/13, compared to Canadian benchmark 16 Figure 4: Overall rating of outpatient cancer care in BC, 2012/13, compared to Canadian benchmark 16 Figure 5: Overall rating of outpatient cancer care in BC and health authorities, 2012/13, compared to Canadian benchmark 17 Figure 6: Overall rating of outpatient cancer care in BC, 2012/13, compared to Canadian benchmark 17 Figure 7: Overall rating of outpatient cancer care in BC and health authorities, 2012/13, compared to Canadian benchmark 18 Figure 8: Overall rating of outpatient cancer care in BC, 2012/13 18 Figure 9: Overall rating of outpatient cancer care in BC and health authorities, 2012/13 19 Figure 10: Overall rating of outpatient cancer care in BC and health authorities, 2012/13, compared to Canadian benchmark 20 Figure 11: Overall rating of outpatient cancer care in BC, 2012/13, compared to Canadian benchmark 21 Figure 12: Dimension scores in BC, 2012/13, compared to Canadian benchmark 22 Figure 13: Dimension scores in BC and health authorities, 2012/13, compared to Canadian benchmark 23 Figure 14: Respect for patient preferences dimension: Composite score and individual question scores in BC, 2012/13, compared to Canadian benchmark 24 Figure 15: Access to care dimension: Composite score and individual question scores in BC, 2012/13, compared to Canadian benchmark 25 Figure 16: Physical comfort dimension: Composite score and individual question scores in BC, 2012/13, compared to Canadian benchmark 26 Figure 17: Coordination and continuity dimension: Composite score and individual question scores in BC, 2012/13, compared to Canadian benchmark 27 Figure 18: Information, communication and education dimension: Composite score and individual question scores in BC, 2012/13, compared to Canadian benchmark 28 Figure 19: Emotional support dimension: Composite score and individual question scores in BC, 2012/13, compared to Canadian benchmark 29 Figure 20: Ten questions with highest ratings in BC, 2012/13, compared to Canadian benchmark 2 U B C C entre for health servi C es and poli C y r e s e a r C h 30 Figure 21: Ten questions with lowest ratings in BC, 2012/13, compared to Canadian benchmark 32 Figure 22: Overall rating of outpatient cancer care in BC, by health authority, 2012/13 replication group compared to 2005/06 33 Figure 23: Overall rating of outpatient cancer care in BC, by health authority, 2012/13 replication group compared to 2005/06 34 Figure 24: Dimension scores in BC, 2012/13 replication group compared to 2005/06 35 Figure 25: Ten questions with highest ratings in BC, 35 2012/13 replication group compared to 2005/06 36 Figure 26: Ten questions with highest ratings in BC, 2012/13 replication group compared to 2005/06 3 p a t i e n t e x p e r i e n C e s w i t h o U t p a t i e n t C a n C e r C a r e i n B r i t i s h C o l U m B ia, 2012/13 About CHSPR The Centre for Health Services and Policy Research (CHSPR) is an independent research centre based in the School of Population and Public Health of the University of British Columbia. Our mission is to stimulate scientific enquiry into health system performance, equity and sustainability. Our faculty are among Canada’s leading experts in primary health care, health care funding, variations in health services utilization, health human resources, and pharmaceutical policy. We promote interdisciplinarity in our research, training, and knowledge translation activities because contemporary problems in health care systems transcend traditional academic boundaries. We are active participants in various policy-making forums and are regularly called upon to provide policy advice in British Columbia, Canada, and abroad. We receive core funding from University of British Columbia. Our research is primarily funded through competitive, peer-reviewed grants obtained from Canadian and international funding agencies. For more information about CHSPR, please visit www.chspr.ubc.ca. 4 U B C C entre for health servi C es and poli C y r e s e a r C h Acknowledgments We would like to acknowledge the work of the many people and organizations that have contrib- uted to the development of this report. First and foremost, the responses of British Columbia (BC) residents to questionnaires asking them about their experiences in receiving outpatient care for treatment of cancer have made this report possible. This includes the more than 13,000 cancer patients who completed surveys: over 6,900 between November 2005 and May 2006, and approximately 6,300 between October 2012 and June 2013. Their contributions of time and perspective made this report possible. The BC Patient Reported Experience Measures Steering Committee (PREMS Committee) has been the primary leader of work to understand the experiences of BC residents with their health care system. Under the direction of the Deputy Minister of Health and Chief Executive Officers of the health authorities of BC, this committee has undertaken numerous province-wide surveys to learn and share information about the health care experiences of BC residents. In 2005/06 and again in 2012/13, they undertook an Ambulatory Oncology Patient Satisfaction Survey to report on the experiences BC patients have with outpatient cancer care. In 2007, and again in 2013, the BC PREMS Steering Committee engaged the UBC Centre for Health Services and Policy Research to assist them in portraying the results of the two surveys. The project has benefitted from the contributions and advice of many individuals. In particular, Lena Cuthbertson, Provincial Director and Co-Chair, and Jennifer May, Project Manager, both with the BC PREMS Committee, provided invaluable insight and direction. Michael A. Murray PhD, an independent health services consultant, researcher, and educator, designed the sampling strategy for the survey and provided valuable input into the interpretation of results. Sandra Broughton, Regional Administrator BC Cancer Agency – Sindi Ahluwalia Hawkins Centre for the Southern Interior, contributeded helpful comments and clarification in response to an earlier version of the report. The National Research Corporation Canada (NRCC) collected survey data and generated reports, under contract with the BC PREMS Steering Committee, that form the basis of the information presented in this report. This report is intended to summarize the results of provincial and health authority reports for this sector, and is therefore descriptive in nature. It relies primarily on documents containing the results of analyses conducted by researchers and analysts at NRCC. Errors or omissions in this report may therefore reflect errors in the original collection or analysis of data. Any conclusions are those of the authors and no official endorsement by the Government of BC is intended or should be inferred. 5 p a t i e n t e x p e r i e n C e s w i t h o U t p a t i e n t C a n C e r C a r e i n B r i t i s h C o l U m B ia, 2012/13 Executive Summary The purpose of this report is to describe British Findings Columbians’ perceptions and reported experi- Findings from BC’s outpatient cancer survey suggest ences with outpatient cancer care, to compare their that BC cancer outpatients are highly satisfied with responses to those of other Canadians, and to deter- the care that they receive, and that there is a pattern of mine if there have been changes in patient experiences high, and increasingly positive ratings of patient satis- for comparable BC patients who were surveyed in faction over time.