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


METHODS
Data 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.


RESULTS
The 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).


CONCLUSIONS
A 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.
Central West Cancer Service, Orange Health Service, Orange, New South Wales, Australia.
Sally M
SM
Butler
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000592:standards / Q000706:statistics & numerical data*; D011878:Radiotherapy / Q000592:standards / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000592:standards / Q000706:statistics & numerical data*
Health services; patient access; radiation oncology; rural; travel distance