P1.08-012 Characterizing Time to Care for Lung Cancer Surgical Patients

Abstract

The Kelowna Thoracic Surgical Group (KTSG), centered in Kelowna, British Columbia (BC), Canada provides care to a geographic area of 807,538 km2. This is 85% of the province of BC and approximately 9 times the size of Austria. A significant portion of this population consists of remote and rural communities. Ensuring equal and prompt access to lung cancer diagnosis and treatment regardless of proximity to treatment center is important not only because of the time sensitivity of care, but also because of the overall healthcare burden of this highly prevalent and often lethal malignancy. A retrospective chart review was performed on all patients seen by the KTSG who came to definitive surgical treatment in Kelowna for a diagnosed or suspected lung cancer between January 2010 and December 2015. Dates were collected at three time-points along the care pathway: Referral, Consult, and Surgical Treatment. We calculated times from referral to consult (RC), consult to treatment (CT), and overall referral to treatment (RT). Demographic information was collected for each of the patients and the distances patients’ lived from the Surgical Centre were determined. The study has received approval from both University of British Columbia – BC Cancer Agency and Interior Health Authority research ethics boards. There were 902 patients in the cohort; 446 local patients who lived within a radius of 100 km or less from Kelowna and 456 distant patients who resided further than 100 km from the city. For the entire group, the median RT was 50.5 days comprised of RC = 6 days, and CT = 42 days. For the local patient group, the median RT was 49 (Interquartile Range (IQR) = 33.75 to 69) days compared to a median of 52.5 (IQR = 36 to 52.5) days for the distant patients. The extreme overlap in the IQR shows no significant clinical difference in time to care between the local and distant patients. Time from referral to treatment for patients with suspected or confirmed lung cancer seen by the IHTSG is similar for both local and distant patients. The equitable times to care with the IHTSG suggests that the current model of patient-doctor communication provides a growing opportunity to mitigate the impact of distance on access to care.