Changes to radiotherapy utilisation in Western NSW after the opening of a local service

Abstract

IntroductionIn 2011, the first radiotherapy centre in Western NSW Local Health District (WNSWLHD) was opened in the city of Orange. Prior to this, patients travelled outside the health service, primarily to Sydney, to receive treatment. The aim of this study was to investigate if the establishment of the new rural radiotherapy service has changed the demographic profile, cancer type, treatment intent and number of patients treated.MethodsData were collected on WNSWLHD patients, 17 years of age and above, who received radiotherapy in either 2010 or 2012 in New South Wales (NSW) or Australian Capital Territory (ACT). The age, gender, treatment intent, cancer type and residential town were recorded.ResultsThe number of patients who accessed radiation increased from 573 to 667 between 2010 and 2012. The corresponding radiotherapy utilisation (RTU) rates were 29.3% in 2010 and 33.4% in 2012, an improvement of 4.1% (P = 0.01, 95% CI 1–7%). Patients travelled 128.5 km less for treatment in 2012 than in 2010 (338.7 km vs. 210.2 km, CI 111–145.5 km, P > 0.0001). All regions had an improvement in the RTU rates apart from the Remote region which decreased by 9% (31–20% in 2012). The number of palliative treatments increased significantly only within the Orange region. The number of male patients for treatments also significantly increased as there were 81 additional treatments (292 vs. 373) as did patients with a respiratory cancer (66 vs. 97).ConclusionsA new radiotherapy service in a sparsely populated health district significantly changed the pattern of radiotherapy use for those who lived only in the Orange region. Treatment capacity at the Orange radiotherapy centre has doubled with the opening of a second linear accelerator since this study was conducted. Thus, a follow‐up study is recommended to ascertain if radiotherapy rates remain low in the regions beyond Orange.

Value of Geographical Information Systems in Analyzing Geographic Accessibility to Inform Radiotherapy Planning: A Systematic Review

“…In scarcely populated areas such as Australia, adding one RT center significantly reduced travel distance and time 69 and increased the RUR by 14% but only for patients who are living within the closest distance category to an RT center. 70 The effect was similar in Canada. 51 An additional RT center in rural Virginia reduced mastectomy rates for breast cancer, and RURs reached levels similar rates to surrounding urban population.…”

“…Several studies used GIS to calculate changes in travel times and distances with the addition of RT centers in areas of need. Mean travel times and distances reduced, 36 , 70 , 71 leading to improved outcomes, including increased RUR, 51 , 58 , 69 reduced RT omission, 5 , 35 , 56 and reduced mastectomy rates. 39 Many standalone components, such as single machine units, were found to have similar standards of care as larger or central departments.…”

Variations in outcomes by residential location for women with breast cancer: a systematic review

“… 100 Similar patterns were also reported for radiotherapy utilisation among all regional patients with cancer. 127 128 The waiting time from radiation oncologist assessment to receiving radiotherapy (for any cancer) has also improved over time. 126 Although implementation of routine reporting of waiting times from diagnosis to commencing radiotherapy by geographical location would help identify when and where delays in referral and commencing treatment occur.…”

Radiotherapy service need in the Pacific Island countries

“…The establishment of new RT facilities has shown to improve utilisation, although evidence is not widespread. 7,8 An Australian study 9 concluded that distance and travel time to RT centres significantly reduced after the opening of an additional RT facility and overall utilisation of RT increased over 3 years. A Polish economic evaluation study also investigated and confirmed the dependence between RT utilisation and distance.…”