Abstract
BackgroundUtilisation of radiation therapy for regional Australia and around the world has been the focus of much health policy the last decade. Radiation therapy centres have been built in Australian regional and rural areas to improve access to radiation therapy and reduce the tyranny of distance as a barrier to access. After this the enablers, barriers and perceptions of patients has been evaluated to determine utilisation once centres have been built. Thisreview looks the impact of rural radiation services in the developed world, barriers and enablers of establishing a rural radiation centre, and patients’ and service providers’ perspectives and preferences around the uptake of rural radiation therapy.MethodsOnline search of peer reviewed literature was undertaken using MeSH terms relating to the topic. Inclusion criteria were regional radiation therapy centres in developing countries, any year of publication, in English, and qualitative or quantitative methodologies. Articles were reviewed by two authors with conflicts discussed with a third.ResultsTwenty three studies addressed the theme directly. Distance barriers have been overcome by building regional centres and health economic burden was lower for government service providers with this strategy. However distance still plays an important role in influencing uptake of radiation therapy. Cultural expectations, influence of the family doctor and perception of care was influential. Carer support, duration of displacement from home, financial impact of the required care and seasonal weather were practical factors on a patient’s decision.ConclusionsRegional radiation therapy centres have improved access to radiation therapy in developing countries. However the complex nuances between socio-economic, cultural and health system factors that influence regional patient’s decision making bears further consideration, as distance is not the only issue.
Highlights
Utilisation of radiation therapy for regional Australia and around the world has been the focus of much health policy the last decade
The utilisation rate in rural and regional Australia is 19% compared to 36% in metropolitan areas [6]
To date, health system barriers and enablers to establishing a rural radiation therapy centre are poorly described in the academic literature
Summary
Utilisation of radiation therapy for regional Australia and around the world has been the focus of much health policy the last decade. The utilisation rate in rural and regional Australia is 19% compared to 36% in metropolitan areas [6] This shows that utilisation and access to radiation therapy, whether it is due to patient or health system factors, still remains a challenge despite the establishment of regional centres. While this appears to be improving over time [7], there is a need to better understand how radiation therapy utilisation and access can be improved. The objective of this review is to explore published literature around the impact of rural radiation therapy services in developed countries
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