|dc.contributor.author||Malalasekera, Marie Ashanya||-|
|dc.description.abstract||Lung cancer is the leading cause of cancer death worldwide, with most patients presenting with advanced stage disease. Missed opportunities for prompt diagnosis leads to increased patient anxiety and distress, under-utilisation of definitive therapy and increased risk of death.
This thesis aimed to identify and address delays occurring in Primary and Secondary healthcare in New South Wales (NSW), Australia. I conducted:
1) A scoping review of the literature evaluating the range and nature of international time intervals to diagnosis and treatment of lung cancer
2) A longitudinal, NSW multi-centre, data linkage study of patient timeframes, against national benchmarks and patient perspectives.
3) A mixed methods substudy exploring clinicians’ reasons for excessive delays observed in (2).
4) A survey of Australian health professionals obtaining insights into perceptions and expectations of timeframes.
• According to literature, major delays generally do not occur in transition from General Practitioner (GP) to specialist care, but moreso within Secondary Care. According to hospital-based clinicians, perceived delays occur in Primary Care, rather than Secondary Care.
• Causes of avoidable delays included patient, provider and systemic factors, such as limited coordination in Secondary Care. Unavoidable delays also occur.
• Strategies to minimise delays include more lung cancer coordinator positions, review of guidelines, and adjustment of patient and clinician expectations of timeliness.
In summary, most delays in time to diagnosis and treatment of lung cancer occur in Secondary Care. Avoidable delays can be mitigated with better coordination of care. Clinicians and patients perceive delays differently, highlighting a need to set appropriate expectations for time to confirm diagnosis and start treatment for lung cancer. These findings have important implications for the multi-disciplinary care of patients with lung cancer in a changing management landscape.||en_AU|
|dc.publisher||University of Sydney||en_AU|
|dc.publisher||Faculty of Medicine and Health||en_AU|
|dc.rights||The author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.||en_AU|
|dc.subject||Australian patterns of care||en_AU|
|dc.title||Delays to diagnosis and treatment of lung cancer in Australia||en_AU|
|dc.type.pubtype||Doctor of Philosophy Ph.D.||en_AU|
|dc.description.disclaimer||Access is restricted to staff and students of the University of Sydney . UniKey credentials are required. Non university access may be obtained by visiting the University of Sydney Library.||en_AU|
|Appears in Collections:||Sydney Digital Theses (University of Sydney Access only)|