The Australian health care system faces a number of challenges.
- An increasing population and an increasingly ageing population
- Increasing complexity of healthcare services and difficulties for patient access
- Patient non-compliance with treatment and missed appointments
- Increasing incidence of cancer
- Incidence rose 26% from 1986 (383 p/100,000) to 2011 (484 p/100,000)
- Increasing survivability of cancer
- In 1986 the 5-year survival rate was 46%. In 2011 it was 67%
- Increasing out-of-pocket costs. For example, patient’s in regional areas often need to travel further for treatment;
- Low health literacy. Only about 40% of adults having a level of literacy they need to make well-informed health decisions;
- Community demand for new technology and increasing costs of medical hardware and pharmaceuticals;
- Imbalances in the supply and distribution of health professionals, which can lead to shortages in outer metropolitan, rural and remote regions and Indigenous communities.
- Almost 50% have a chronic disease, meaning a more frequent use of services, higher healthcare costs and poorer outcomes. (AIHW).
The model of patient navigation was first developed by Dr Harold Freeman at the Harlem Hospital in New York in 1990, with the aim of removing the barriers to screening, improving early detection rates and improving cancer care for the disadvantaged. His work showed that attaching patient navigators to newly diagnosed breast cancer patients helped improve the five-year survival rate from 39% to 70%.
In 1989, the American Cancer Society issued a “Report to the Nation on Cancer in the Poor”. The report found that the most critical issues related to cancer and the poor are:
- Poor people face substantial barriers in seeking and obtain cancer care and often do not seek care if they cannot pay for it.
- Poor people endure greater pain and suffering from cancer.
- Poor people and their families often make extraordinary personal sacrifices to obtain and pay for care.
- Fatalism about cancer is common among the poor and may prevent them from seeking care.
- Current cancer education programs are culturally insensitive and irrelevant to many poor people.
Today patient navigators play an important role in the US health system where they have improved outcomes for minority groups and low income families. Navigators are shown to increase survival rates through increased screening and early detection, reduced unplanned hospital admissions, increased treatment compliance and improved health literacy.
For most people, receiving a cancer diagnosis is a life changing event.
While doctors, nurses and specialists focus on treating the cancer, many patients are left alone to deal with the trauma of the diagnosis. Outside of their family, they often face a vacuum of support, with many questions unanswered, and emotions such as grief, anger, depression and fear running high.
At these times, access to professional counselling is vital. In pilot projects with health services, the CanCare Counselling program works to give patients, their families and carers better access to help and support at a time they need it most.
By improving access to psycho-social services, CanCare aims to help patients live longer, with a higher quality of life.