Access, continuity of care and consultation quality: Which best predicts urgent cancer referrals from general practice?

Stephen Rogers*, Carolynn Gildea, David Meechan, Richard Baker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Background For some cancers, late presentation is associated with poor survival. In England, less than half of patients are diagnosed following a general practitioner-initiated urgent referral. We explore whether particular practice or practitioner characteristics are associated with use of the urgent referral system. Methods The study sample was 603/614 practices in the East Midlands. Logistic regression models were fitted to investigate relationships between cancer detection rate, how easy it is to book appointments quickly, in advance or with a preferred doctor, and whether patients have confidence and trust in the doctor. Results The percentage of patients who definitely have confidence and trust in the doctor was positively associated with the cancer detection rate [odds ratio = 1.08 (95% confidence interval (CI) 1.01, 1.15) per 10 percentage points]. When all four survey variables were modelled together, the percentage of patients who were able to see a preferred doctor was negatively associated with the cancer detection rate [odds ratio = 0.93 (95% CI 0.88, 0.98) per 10 percentage points]. Conclusions Our analyses suggest that in the UK National Health Service, confidence and trust in the doctor may be more important in cancer detection than the ease of access or whether there is choice of doctor.

Original languageEnglish
Pages (from-to)658-666
Number of pages9
JournalJournal of Public Health
Volume36
Issue number4
DOIs
Publication statusPublished - 1 Dec 2014

Bibliographical note

Publisher Copyright:
© The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health.

Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.

Keywords

  • cancer
  • diagnosis
  • primary care

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