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Can Fam Physician. 2016 Oct;62(10):e599-e607.

Family physician access to and wait times for cancer diagnostic investigations: Regional differences among 3 provinces.

Author information

1
Senior Research Associate for the Ontario Renal Network of Cancer Care Ontario in Toronto, Ont, and was with the Department of Prevention and Cancer Control at the time of manuscript development. andriana.barisic@renalnetwork.on.ca.
2
Research Associate at Cancer Care Ontario and was a master's student in the Department of Pharmacology and Toxicology at the University of Toronto.
3
Staff scientist and Manager of Research and Evaluation at Cancer Care Ontario and Adjunct Professor in the Institute for Health Policy, Management and Evaluation at the University of Toronto.
4
Chief Research Officer at Cancer Care Ontario.
5
Professor and a senior biostatistician in the Department of Family and Community Medicine at the University of Toronto.
6
Chair of the College of Family Physicians of Canada's Cancer Care Program of the Section of Communities of Practice in Family Medicine and Vice-Dean of the Office of Continuing Competency and Assessment in the Faculty of Health Sciences and Professor in the Department of Family Medicine at the University of Manitoba in Winnipeg.
7
Professor in the Research Unit for General Practice in the Department of Public Health at Aarhus University in Denmark.
8
Giblon Professor and Vice-Chair of Research in the Department of Family and Community Medicine at the University of Toronto and Director of Knowledge Translation Research in the Health Services Research Program at the Ontario Institute for Cancer Research.

Abstract

OBJECTIVE:

To examine provincial and regional differences in FPs' direct access to cancer diagnostic investigations and advice from other specialists regarding investigations and referrals, and to explore FPs' perceptions about wait times for diagnostic investigations and receipt of results.

DESIGN:

A cross-sectional, online survey.

SETTING:

British Columbia, Manitoba, and Ontario.

PARTICIPANTS:

A sample of FPs from participating provinces.

MAIN OUTCOME MEASURES:

Direct FP access to various diagnostic investigations and advice from other specialists regarding investigations and referrals; FPs' perceptions about wait times for diagnostic investigations ordered directly; and FPs' perceptions about wait times for results.

RESULTS:

A total of 1054 surveys were completed by FPs from British Columbia (n = 229), Manitoba (n = 228), and Ontario (n = 597). Distance from a cancer centre was not significantly associated with direct access to or wait times for diagnostic investigations for most of the investigations studied; however, provincial differences were observed. Family physicians in Manitoba and British Columbia were 30% to 45% less likely to report having direct access to endoscopy and some imaging investigations compared with FPs in Ontario. Family physicians in Manitoba and British Columbia were also at increased odds of waiting longer than 12 weeks for endoscopy investigations and longer than 4 weeks for imaging investigations compared with FPs in Ontario. Most FPs reported wait times of less than 2 weeks for imaging results; however, the proportion of FPs who waited longer than 2 weeks for colonoscopy results ranged from 15% in Ontario to 96% in British Columbia.

CONCLUSION:

Given the disparities observed among provinces, there is an opportunity for provinces to learn from one another to improve direct access to and shorten wait times for diagnostic investigations. This in turn has the potential to shorten the primary care interval for cancer diagnostic assessment.

PMID:
27737995
PMCID:
PMC5063786
[Indexed for MEDLINE]
Free PMC Article

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