title: How rural and urban patients in Australia with colorectal or breast cancer experience choice of treatment provider: A qualitative study.
abstract: Modern healthcare systems promote patient choice of cancer treatment provider, but little is known about how place of residence influences decision-making. This research explored how rural and urban patients with breast or colorectal cancer experience choice of cancer treatment provider in Victoria, Australia. Realist thematic analysis of 43 semi-structured telephone interviews identified little active participation in decision-making regardless of area of residence or cancer diagnosis. Perceptions of choice were impacted by urgency for treatment, insurance status and access to providers, a key issue for rural patients. All patients wanted high quality care, but needed to trust health professional's recommendations. Rural patients experienced more complex decision-making, balancing a range of social factors with perceptions about quality of accessible care. Further research into variation in quality of care and complex cancer pathways for rural and urban cancer patients is warranted to inform choices and enhance patient-centred care.
authors.affiliation: Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Vic., Australia.|Department of General Practice and Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia.
authors.forename: R
authors.identifier: http://orcid.org/0000-0003-0448-9125
authors.initials: R
authors.lastname: Bergin
authors.affiliation: Department of General Practice and Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia.
authors.forename: J
authors.initials: J
authors.lastname: Emery
authors.affiliation: Division of Surgery, Ballarat Health Services, Ballarat, Vic., Australia.
authors.forename: R
authors.initials: R
authors.lastname: Bollard
authors.affiliation: Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Vic., Australia.
authors.forename: V
authors.initials: V
authors.lastname: White
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001943:Breast Neoplasms / Q000628:therapy*; D002755:Choice Behavior; D015179:Colorectal Neoplasms / Q000628:therapy*; D003657:Decision Making; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072103:Oncologists; D036301:Qualitative Research; D011787:Quality of Health Care; D012424:Rural Population; D035502:Trust; D014505:Urban Population; D014739:Victoria
keywords: access; cancer; patient experience; quality of care; rural health