Rural: Overview

The report is based on prospectively collected data for 311 patients treated for stages 1 to 3 colorectal cancer by four surgeons in the 110-bed Mount Gambier Hospital, between 1 February 2006 and 31 January 2020. Of these patients, the median age was 71 years (spanning from 63 to 78 years) and 55% were men.

Overall five‐year survival in this study of 79% exceeded the most recent reported value for Australia (2011–2015: 69.9%), and contrasts with a Californian study which found that rural residence was associated with poorer cancer‐specific mortality.

Published data on outcomes beyond 10 years after colorectal cancer surgery are limited, but the overall 10‐year survival rate of 45% stated in the new report is similar to the figures reported by an earlier study in Fremantle (44%).

King Island residents needing care are forced to deal with the Patient Travel Assistance Scheme (PTAS) — a federally-funded and state-run service to partially fund the travel expenses of people forced to leave their homes in rural and regional Tasmania for health services. But the PTAS program is often impractical and has residents jumping through hoops.

Abstract
Background: Reasons for elective surgery cancellations and their impact vary from one institution to another. Cancellations have emotional and financial implications for patients and their families. Our service has a particularly broad and geographically diverse patient population, hence we sought to examine these impacts in our service.

Methods: We identified families with procedural cancellations and administered a telephone questionnaire. Survey items included the reason for and timing of cancellation, how the family was informed, the mode of transport and distance travelled to the hospital, associated leave from work, expenses, whether the child was required to fast, missed school, as well as the child's and parent's emotional responses to the cancellation, along with overall parental satisfaction with how the cancellation was handled.

Results: During our study period a total of 7870 procedures were booked. 6734 (86%) of these were completed and 1136 (14%) were cancelled, with 6% cancelled on the day of surgery. In 750 (66%) of these cancellations, families were successfully contacted by telephone and agreed to participate. Of these 305 (41%) cancellations were family-initiated and 444 (59%) were hospital-initiated, with these hospital-initiated cancellations occurring closer to scheduled surgery. The most common cause of cancellation was that the child could not undergo the procedure due to illness (22%) or being unable attend the hospital (14%). The greatest disruption to families and children occurred when procedures were cancelled late, particularly when the cancellation occurred on the day of the planned procedure.