title: Inequalities in reported cancer patient experience by socio-demographic characteristic and cancer site: evidence from respondents to the English Cancer Patient Experience Survey.
abstract: Patient experience is a critical dimension of cancer care quality. Understanding variation in experience among patients with different cancers and characteristics is an important first step for designing targeted improvement interventions. We analysed data from the 2011/2012 English Cancer Patient Experience Survey (n = 69,086) using logistic regression to explore inequalities in care experience across 64 survey questions. We additionally calculated a summary measure of variation in patient experience by cancer, and explored inequalities between patients with cancers treated by the same specialist teams. We found that younger and very old, ethnic minority patients and women consistently reported worse experiences across questions. Patients with small intestine/rarer lower gastrointestinal, multiple myeloma and hepatobiliary cancers were most likely to report negative experiences whereas patients with breast, melanoma and testicular cancer were least likely (top-to-bottom odds ratio = 1.91, P < 0.0001). There were also inequalities in experience among patients with cancers treated by the same specialty for five of nine services (P < 0.0001). Specifically, patients with ovarian, multiple myeloma, anal, hepatobiliary and renal cancer reported notably worse experiences than patients with other gynaecological, haematological, gastrointestinal and urological malignancies respectively. Initiatives to improve cancer patient experience across oncology services may be suitably targeted on patients at higher risk of poorer experience.
authors.affiliation: Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK.
authors.forename: C L
authors.initials: CL
authors.lastname: Saunders
authors.forename: G A
authors.initials: GA
authors.lastname: Abel
authors.forename: G
authors.initials: G
authors.lastname: Lyratzopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004739:England / Q000453:epidemiology; D005006:Ethnicity / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D016017:Odds Ratio; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: healthcare inequalities; hospital; neoplasms; oncology service; patient satisfaction; quality of health care