Immigrants' perceptions of the quality of their cancer care

An Australian comparative study, identifying potentially modifiable factors

D. Goldstein, Melanie L Bell, Phyllis Butow, M. Sze, L. Vaccaro, S. Dong, W. Liauw, R. Hui, M. Tattersall, W. Ng, R. Asghari, C. Steer, J. Vardy, P. Parente, M. Harris, N. V. Karanth, M. King, A. Girgis, M. Eisenbruch, M. Jefford

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Recent data show a falling cancer mortality in the general population without a similar shift in immigrant outcomes, leading to a greater cancer burden and mortality for immigrants. Our aims were to compare perceived patterns of care in immigrants and native-born cancer patients. Patients and methods: This was a hospital-based sample of first-generation immigrants and Australian-born Anglo patients in the first year following diagnosis. It was restricted to Chinese, Arabic, or Greek speakers. Eligible participants, recruited via 16 oncology clinics, were over 18, with cancer (any type or stage), and having commenced treatment at least 1 month previously. Five hundred and seventy-one CALD patients (comprising 145 Arabic, 248 Chinese, and 178 Greek) and a control group of 274 Anglo-Australian patients participated. Results: Immigrants had difficulty communicating with the doctor (73% versus 29%) and understanding the health system (38% versus 10%). Differences were found in 'difficulty knowing who to see' (P = 0.0002), 'length of time to confirm diagnosis' (P = 0.04), wanting more choice about a specialist and hospital (P < 0.0001); being offered the opportunity to see a counselor (P < 0.0001); and actually seeing one (P < 0.0001). There were no significant self-reported differences regarding how cancer was detected, time to see a health professional, or type first seen; however, immigrants reported difficulty knowing who to see. Previous studies showed differences in patterns of care according to socioeconomic status (SES) and educational level. Despite adjusting for age, sex, education, marital status, SES, time since diagnosis, and type of cancer, we did not find significant differences. Instead, we found that understanding of the health system and confidence understanding English were important factors. Conclusions: This study confirmed that immigrants with cancer perceive an inferior quality of cancer care. We highlight potentially modifiable factors including assistance in navigating the health system, translated information, and cultural competency training for health professionals.

Original languageEnglish (US)
Article numbermdu182
Pages (from-to)1643-1649
Number of pages7
JournalAnnals of Oncology
Volume25
Issue number8
DOIs
StatePublished - 2014
Externally publishedYes

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Neoplasms
Health
Social Class
Accidental Falls
Cultural Competency
Health Information Systems
Sex Education
Mortality
Quality of Health Care
Marital Status
Population Groups
Control Groups
Population
Therapeutics

Keywords

  • Cancer outcomes
  • Care co-ordination
  • Health services
  • Immigrant health

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Immigrants' perceptions of the quality of their cancer care : An Australian comparative study, identifying potentially modifiable factors. / Goldstein, D.; Bell, Melanie L; Butow, Phyllis; Sze, M.; Vaccaro, L.; Dong, S.; Liauw, W.; Hui, R.; Tattersall, M.; Ng, W.; Asghari, R.; Steer, C.; Vardy, J.; Parente, P.; Harris, M.; Karanth, N. V.; King, M.; Girgis, A.; Eisenbruch, M.; Jefford, M.

In: Annals of Oncology, Vol. 25, No. 8, mdu182, 2014, p. 1643-1649.

Research output: Contribution to journalArticle

Goldstein, D, Bell, ML, Butow, P, Sze, M, Vaccaro, L, Dong, S, Liauw, W, Hui, R, Tattersall, M, Ng, W, Asghari, R, Steer, C, Vardy, J, Parente, P, Harris, M, Karanth, NV, King, M, Girgis, A, Eisenbruch, M & Jefford, M 2014, 'Immigrants' perceptions of the quality of their cancer care: An Australian comparative study, identifying potentially modifiable factors', Annals of Oncology, vol. 25, no. 8, mdu182, pp. 1643-1649. https://doi.org/10.1093/annonc/mdu182
Goldstein, D. ; Bell, Melanie L ; Butow, Phyllis ; Sze, M. ; Vaccaro, L. ; Dong, S. ; Liauw, W. ; Hui, R. ; Tattersall, M. ; Ng, W. ; Asghari, R. ; Steer, C. ; Vardy, J. ; Parente, P. ; Harris, M. ; Karanth, N. V. ; King, M. ; Girgis, A. ; Eisenbruch, M. ; Jefford, M. / Immigrants' perceptions of the quality of their cancer care : An Australian comparative study, identifying potentially modifiable factors. In: Annals of Oncology. 2014 ; Vol. 25, No. 8. pp. 1643-1649.
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abstract = "Background: Recent data show a falling cancer mortality in the general population without a similar shift in immigrant outcomes, leading to a greater cancer burden and mortality for immigrants. Our aims were to compare perceived patterns of care in immigrants and native-born cancer patients. Patients and methods: This was a hospital-based sample of first-generation immigrants and Australian-born Anglo patients in the first year following diagnosis. It was restricted to Chinese, Arabic, or Greek speakers. Eligible participants, recruited via 16 oncology clinics, were over 18, with cancer (any type or stage), and having commenced treatment at least 1 month previously. Five hundred and seventy-one CALD patients (comprising 145 Arabic, 248 Chinese, and 178 Greek) and a control group of 274 Anglo-Australian patients participated. Results: Immigrants had difficulty communicating with the doctor (73{\%} versus 29{\%}) and understanding the health system (38{\%} versus 10{\%}). Differences were found in 'difficulty knowing who to see' (P = 0.0002), 'length of time to confirm diagnosis' (P = 0.04), wanting more choice about a specialist and hospital (P < 0.0001); being offered the opportunity to see a counselor (P < 0.0001); and actually seeing one (P < 0.0001). There were no significant self-reported differences regarding how cancer was detected, time to see a health professional, or type first seen; however, immigrants reported difficulty knowing who to see. Previous studies showed differences in patterns of care according to socioeconomic status (SES) and educational level. Despite adjusting for age, sex, education, marital status, SES, time since diagnosis, and type of cancer, we did not find significant differences. Instead, we found that understanding of the health system and confidence understanding English were important factors. Conclusions: This study confirmed that immigrants with cancer perceive an inferior quality of cancer care. We highlight potentially modifiable factors including assistance in navigating the health system, translated information, and cultural competency training for health professionals.",
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AU - Goldstein, D.

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AU - Butow, Phyllis

AU - Sze, M.

AU - Vaccaro, L.

AU - Dong, S.

AU - Liauw, W.

AU - Hui, R.

AU - Tattersall, M.

AU - Ng, W.

AU - Asghari, R.

AU - Steer, C.

AU - Vardy, J.

AU - Parente, P.

AU - Harris, M.

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AU - Eisenbruch, M.

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N2 - Background: Recent data show a falling cancer mortality in the general population without a similar shift in immigrant outcomes, leading to a greater cancer burden and mortality for immigrants. Our aims were to compare perceived patterns of care in immigrants and native-born cancer patients. Patients and methods: This was a hospital-based sample of first-generation immigrants and Australian-born Anglo patients in the first year following diagnosis. It was restricted to Chinese, Arabic, or Greek speakers. Eligible participants, recruited via 16 oncology clinics, were over 18, with cancer (any type or stage), and having commenced treatment at least 1 month previously. Five hundred and seventy-one CALD patients (comprising 145 Arabic, 248 Chinese, and 178 Greek) and a control group of 274 Anglo-Australian patients participated. Results: Immigrants had difficulty communicating with the doctor (73% versus 29%) and understanding the health system (38% versus 10%). Differences were found in 'difficulty knowing who to see' (P = 0.0002), 'length of time to confirm diagnosis' (P = 0.04), wanting more choice about a specialist and hospital (P < 0.0001); being offered the opportunity to see a counselor (P < 0.0001); and actually seeing one (P < 0.0001). There were no significant self-reported differences regarding how cancer was detected, time to see a health professional, or type first seen; however, immigrants reported difficulty knowing who to see. Previous studies showed differences in patterns of care according to socioeconomic status (SES) and educational level. Despite adjusting for age, sex, education, marital status, SES, time since diagnosis, and type of cancer, we did not find significant differences. Instead, we found that understanding of the health system and confidence understanding English were important factors. Conclusions: This study confirmed that immigrants with cancer perceive an inferior quality of cancer care. We highlight potentially modifiable factors including assistance in navigating the health system, translated information, and cultural competency training for health professionals.

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