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PTU-129 Do gastrointestinal cancer patients want to decide where they have tests and surgery? a questionnaire study of provider choice and information needs
  1. BE Byrne1,
  2. OD Faiz2,
  3. A Darzi3,
  4. CA Vincent4
  1. 1Patient Safety Translational Research Centre, Imperial College London, London
  2. 2Surgical Epidemiology, Trials and Outcome Centre, St Mark’s Hospital, Harrow
  3. 3Surgery and Cancer, Imperial College London, London
  4. 4Department of Experimental Psychology, University of Oxford, Oxford, UK

Abstract

Introduction Choice of provider has been an important strategy among policy makers over recent years, intended, in part, to drive improvements in quality and efficiency of health care. Provider choice has been relatively under-studied among patients with cancer, compared with benign disease. This study examines decision-making experiences, preferences and information needs among patients who have had surgery for gastrointestinal cancer.

Method This questionnaire study used the single-item Control Preferences Scale to determine patients’ experiences and preferences when being referred for tests, and choosing where to have surgery. Participants used a Likert scale to rate the importance of 23 information items covering a variety of structures, process and outcomes at hospital- and department-level. Participants were recruited by post and online.

Results 463 responses were included. Where indicated, 334 of 415 (80.5%) respondents had upper gastrointestinal cancer. Postal response rates were higher than online (47.2% vs 23.1%,p < 0.001). Patients reported very low levels of involvement in provider choice, with their doctor deciding where they underwent tests or surgery in 77.0% and 81.8% of cases, respectively. Over two-thirds of participants would have preferred greater involvement in provider choice. Information on how long cancer patients wait for treatment, annual operative volume and postoperative mortality rate, as well as retained foreign bodies and infection rates were considered very important.

Conclusion There is a substantial unmet desire for greater involvement in provider choice among gastrointestinal cancer patients. Participants in this study attached particular importance to surgery-specific information. Improving involvement and information provision will require a coordinated approach in both primary and secondary care. Greater involvement in decision-making may increase satisfaction and contribute to a greater sense of control among these patients.

Disclosure of interest None Declared.

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