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  • Disease Site
    • Breast
      • Breast cancer screening
      • Screening in underserved populations
      • Breast cancer diagnosis wait time
      • Capture of stage
      • Stage distribution
      • Surgery
        • Breast cancer resections that are mastectomies
        • The use of breast-conserving surgery versus mastectomies for breast cancer resections
      • Radiation therapy
        • Post-operative radiation therapy for stage I or II breast cancer patients
      • Place of death
      • Adult clinical trial participation
      • Cancer research investment
      • Breast cancer screening outside recommended guidelines
      • Incidence and mortality rates
      • Five-year net survival by income quintile for several cancers in Canada
    • Colorectal
      • Colorectal cancer screening
      • Geographic variation in colorectal cancer risk
      • Screening in underserved populations
      • Colorectal cancer diagnosis wait time
      • Capture of stage
      • Stage distribution
      • Surgery
        • Removal and examination of 12 or more lymph nodes in colon resections
        • Resection rates for stage II or III rectal cancer, stage III colon cancer and stage II or IIIA non-small cell lung cancer patients
      • Radiation therapy
        • Pre-operative radiation therapy for patients with stage II or III rectal cancer
      • Post-operative chemotherapy for stage III colon cancer patients
      • Place of death
      • Adult clinical trial participation
      • Cancer research investment
      • Incidence and mortality rates
      • Five-year net survival by income quintile for several cancers in Canada
    • Lung
      • Capture of stage
      • Stage distribution
      • Geographic variation in lung cancer risk
      • Resection rates for stage II or IIIA Non-snmall cell lung cancer patients
      • Post-operative chemotherapy for stage II or IIIA non-small cell lung cancer patients
      • Place of death
      • Adult clinical trial participation
      • Cancer research investment
      • Incidence and mortality rates
      • Five-year net survival by income quintile for several cancers in Canada
    • Prostate
      • PSA testing
      • Prostate risk profile
      • Capture of stage
      • Stage distribution
      • Prostate wait times for surgery
      • Prostate wait times for radiation therapy
      • Radical prostatectomy: open versus laparoscopic surgery
      • Prostate patterns of care: radiation and surgical treatment
      • Prostate access to palliative radiation
      • Prostate clinical trials participation
      • Adult clinical trial participation
      • Prostate cancer research investment
      • Cancer research investment
      • Incidence & Mortality Rates
      • Five-year net survival by income quintile for several cancers in Canada
    • Cervical
      • Human papillomavirus (HPV) vaccination
      • Cervical cancer screening
      • Screening in underserved populations
    • Pancreas
      • Incidence and mortality rates
    • Stage Distribution
  • Province & Territory
  • 1. Prevention
  • 2. Screening
  • 3. Diagnosis
  • 4. Treatment
  • 5. Person-Centred Perspective
  • 6. Research
  • 7. Appropriateness
  • 8. Long-term outcomes
  • Smoking prevalence
  • Smoking behaviours in current cancer patients
  • Smoking cessation
  • Second-hand smoke exposure
  • Geographic variation in lung cancer risk
  • Alcohol consumption
  • Adult overweight and obesity
  • Active transportation
  • Physical inactivity
  • Human papillomavirus (HPV) vaccination
  • Fruit and vegetable consumption
  • Geographic variation in colorectal cancer risk
  • Cervical cancer screening
  • Breast cancer screening
  • Colorectal cancer screening
  • PSA testing
  • Screening in underserved populations
  • Breast cancer diagnosis wait times
  • Colorectal cancer diagnosis wait times
  • Capture of stage
  • Stage distribution
  • Prostate risk profile
  • Surgery
  • Radiation therapy
  • Systemic therapy
  • Removal and examination of 12 or more lymph nodes in colon resections
  • Resection rates for stage II or III rectal cancer, stage III colon cancer and stage II or IIIA non-small cell lung cancer patients
  • The use of breast-conserving surgery versus mastectomies for breast cancer resections
  • Breast cancer resections that are mastectomies
  • High-risk, resource-intensive surgeries for esophageal, pancreatic, liver, lung and ovarian cancers in Canada
  • Prostate wait times for surgery
  • Radical prostatectomy: open versus laparoscopic surgery
  • Radiation therapy wait times
  • Radiation therapy utilization and capacity
  • Pre-operative radiation therapy for patients with stage II or III rectal cancer
  • Post-operative radiation therapy for patients with stage I or II breast cancer
  • Prostate wait times for radiation therapy
  • Prostate patterns of care: radiation and surgical treatment
  • Post-operative chemotherapy for stage III colon cancer patients
  • Post-operative chemotherapy for patients with stage II or IIIA non-small cell lung cancer
  • Screening for distress
  • Patient satisfaction
  • Place of death
  • Prostate access to palliative radiation
  • Adult clinical trial participation
  • Prostate clinical trials participation
  • Pediatric clinical trial participation
  • Cancer research investment
  • Prostate cancer research investment
  • Breast cancer screening outside of guidelines
  • Breast cancer mastectomies done as day surgery
  • Intensive care use in the last two weeks of life
  • Breast cancer
  • Lung cancer
  • Colorectal cancer
  • Prostate cancer
  • Pancreatic cancer
  • Five-year net survival by income quintile for several cancers in Canada
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  • 5. Person-Centred Perspective
  • Patient satisfaction

Patient satisfaction

  • Charts and Tables

    Charts and Tables

    Figure 5.2

    Percentage of patients reporting negative rating across dimensions of care and for overall quality of care, by province – from 2011 to 2013

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      Data Table

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    Data provided by individual provincial cancer agencies.
    Data source: National Research Corporation Canada’s Ambulatory Oncology Patient Satisfaction Survey results

    Data Table

    Province / TerritoryDimension of CareNegative Response (N)Negative Rating (%)Number of Respondents
    ABAccess to care2875.05,705
    SKAccess to care1835.13,603
    MBAccess to care2015.53,679
    NSAccess to care1454.63,121
    PEAccess to care494.71,052
    ABCo-ordination and continuity of care3833.510,864
    SKCo-ordination and continuity of care1623.25,044
    MBCo-ordination and continuity of care2773.87,279
    NSCo-ordination and continuity of care1692.86,027
    PECo-ordination and continuity of care683.22,129
    ABEmotional support1,89324.07,892
    SKEmotional support91130.72,970
    MBEmotional support90821.54,214
    NSEmotional support86019.44,442
    PEEmotional support32821.51,528
    ABInformation, communication and education1,1169.511,750
    SKInformation, communication and education66911.65,754
    MBInformation, communication and education79910.67,566
    NSInformation, communication and education4357.45,850
    PEInformation, communication and education1777.82,263
    ABPhysical comfort1123.43,309
    SKPhysical comfort563.21,741
    MBPhysical comfort582.82,066
    NSPhysical comfort512.71,869
    PEPhysical comfort91.7534
    ABRespect for patient preferences4606.17,523
    SKRespect for patient preferences2487.03,522
    MBRespect for patient preferences3757.54,967
    NSRespect for patient preferences1754.24,127
    PERespect for patient preferences724.91,477
    ABOverall quality of care510.95,526
    SKOverall quality of care110.91,292
    MBOverall quality of care381.42,759
    NSOverall quality of care90.33,041
    PEOverall quality of care80.71,087

    + Expand Table

    Data provided by individual provincial cancer agencies.
    Data source: National Research Corporation Canada’s Ambulatory Oncology Patient Satisfaction Survey results

  • Data specifications

    Data specifications

    Patient satisfaction – all dimensions of care

    Definition: NRC AOPSS Survey (self-reported data); see inclusion/exclusion criteria below – provincial % Negative rating, summary indicator for the dimensions surveyed: Access to Care, Coordination and Continuity of Care, Emotional Support Information, Communication & Education, Physical Comfort, Respect for Patient Preferences, Overall Quality of Care

    Data source: Reported by provincial cancer agencies or equivalent to the Canadian Partnership Against Cancer

    Measurement timeframe:
    AB: Feb-Aug 2012
    MB: Jun-Oct 2011
    NS: Jun-Sept 2012
    PE: Nov 2012-Jan 2013
    SK: Apr-Jun 2011


    Patient satisfaction – emotional support dimension

    Definition: NRC Picker AOPSS Survey (self-reported data) – provincial % negative rating for the 7 stratifications for emotional support:

    1. By site (Breast, Cervix/Uterine/Ovarian, Colorectal/Bowel, Lung and Prostate/testicular)
    2. Reason for Treatment (first time cancer diagnosis, repeat cancer diagnosis)
    3. Time since Diagnosis (less than 6 months ago, between 6-12 months ago, between 1 and 2 years ago, between 2 to 5 years ago and more than 5 years ago)
    4. Education (< Sec. School, Sec. School Grad and Post-Sec. Grad)
    5. Health Status (Poor, Fair, Good, Very Good and Excellent)
    6. Sex (Female and Male)
    7. Age (<50, 50-74 and 75+)

    Data source: Reported by provincial cancer agencies or equivalent to the Canadian Partnership Against Cancer
    Measurement timeframe:
    AB: Feb-Aug 2012
    MB: Jun-Oct 2011
    NS: Jun-Sept 2012
    PE: Nov 2012-Jan 2013
    SK: Apr-Jun 2011


    National Research Corporation Canada

    Ambulatory Oncology Patient Satisfaction Survey

    Inclusion and Exclusion Criteria

    Exclusion Criteria:

    • Deceased patients
    • Patients less than 18 years of age (based on date of birth at time of data extraction for surveying)
    • Patients with no known fixed address
    • Patients who do not have a confirmed cancer diagnosis (even if they have received treatment in the facility) including in-situ, benign haematology and/or non-malignant cancers (for example myeloproliferative diseases) or those going through a diagnostic assessment process
    • Patients who received only inpatient services
    • Patients who have notified the hospital that they wish to be excluded from mailing list.

    Inclusion Criteria:

    • Patients who have received active treatment in an ambulatory setting in the past 3 months
    • Patients with a confirmed diagnosis of Cancer (include those patients with diseases identified as invasive, with a 3 in the 5th position of the ICD-O-3 histology code (malignant, primary site)
    • Have undergone active outpatient treatment in the past 3 months
    • Are 18 years or older (based on date of birth at time of data extraction for surveying)

    The table below highlights where sampling criteria for jurisdictions varies from the criteria outlined above.

    Jurisdiction Deviations from the standard Inclusion/Exclusion criteria
    Data elements in addition to those required as per 
    NRC Implementation Manual 
    Alberta Inclusion:

    • Those who have been on treatment for six months.

     

    • Can identify patients who received chemotherapy and radiation treatments however surgery is not captured until approximately a year after diagnosis so the vast majority of patients will not have surgical information.
    • Will identify patients who received IV and/or oral chemotherapy at the tertiary centres. However at the Associate and Community cancer centres, are unable to determine the type of systemic treatment received. This will result in the inclusion of patients who received hormones and immunotherapy as well as those who received chemotherapy.
    • Alberta will use the ICD code for invasive cancer as used by the other provinces.
    • Will use age at diagnosis as prescribed on the Implementation Manual.
    Nova ScotiaSurveyed Point in Time Summer 2012 Exclusion:

    • Exclude in-situ bladder.
    • There is a flag set on each case where ‘ambiguous' terms appear on the pathology report. The histology could still be classified as /3 (invasive), but if this flag were set, the patient would not be approached.

     

    Oral Chemotherapy patients:

    • There is a problem in identifying these patients. They are not specifically included or excluded. Due to limitations in the IT system, an algorithm has been developed for selecting patients that are most likely to be receiving chemotherapy based on visits to medical oncologists so oral chemotherapy patients could be part of that algorithm. Certainly oral chemotherapy is increasing and they may have different issues or not identify themselves as chemotherapy patients in the survey.
    SaskatchewanSample point in time every 1 – 2 years Exclusions:

    • Patients who are on injections (determined by a comprehensive drug master list from Care Services)
    • Patients who have restrictions in Ceres/Eureka/CMS
    • Patients with specific chemo/radiation events

     

    Inclusions:

    • Patients who have a specific COPS institution as a scheduled event
    • Haematology patients (as there is no way currently to exclude those patients)
    • Have undergone active outpatient treatment in the past six months.
    Oral Chemotherapy patients:

    • Oral chemotherapy patients included in sample size. Patients not receiving IV chemotherapy are not excluded from the serious side effects and care that they should receive and expect during their cancer care service. Many cancer patients are on oral chemotherapy, such as the brain, GI, pancreatic cancer patients that require the same information, education, support, follow up and side effects management as do the IV chemotherapy patients.
    Manitoba
    • As per criteria above.
    Prince Edward Island
    • As per criteria above.

    Data and measurement considerations

    • While the provincial surveys used to produce the patient satisfaction results are all based on the AOPSS tool, inclusion criteria for patients may vary among provinces. As well, the results presented in this report are based on the latest surveys conducted in each province, but the years the surveys were conducted vary among provinces (from 2011 to 2013). While progress has been made, work is still needed to ensure that inclusion and exclusion criteria are consistent across all hospitals and jurisdictions to allow results to be compared within and among jurisdictions. Any deviation from these criteria are identified above and should be considered when interpreting results.
    • In Nova Scotia, Manitoba and Prince Edward Island, surveyed patients had received disease-oriented treatment within three months of the survey period, whereas in Alberta and Saskatchewan, patients had had treatment within six months of the survey.
    • The survey consistently captures data on patients receiving radiation treatment, but chemotherapy treatment data collection may vary by province (e.g., whether patients receiving oral chemotherapy alone were included rather than only those receiving intravenous chemotherapy).
    • It is important to be cautious when interpreting results in this section given that individuals may not have recalled all facets of care that took place when they received disease-oriented treatment three to six months earlier.
  • Related indicators

    Related Indicators

    Screening for distress

    Current state of Patient Reported Outcomes implementation, by province, as of April 2017
    Province‡ Disease sites Data capture method Number of clinical sites using ESAS/number of sites providing cancer therapy Frequency of screening
    British Columbia — Paper (with electronic re-entry) 6/6 —
    Alberta All Paper (with electronic re-entry) 17/17 sites on paper (15/17 sites have electronic re-entry)
    • New patient oncology visit
    • Follow-up visits
    • Once per cycle of chemotherapy
    • Beginning, middle and end of radiation therapy
    Saskatchewan All Paper (with electronic re-entry) 18/18 (2 tertiary sites, 16 community oncology centres)
    • Once for every new patient at new patient consultation
    • Once for every patient referred to pain and symptom management clinic
    • Once for every radiation therapy patient while on radiation therapy
    Manitoba All but head & neck Paper (with electronic re-entry) 22 At every physician visit
    Ontario All except in-situ melanoma (malignant skin and malignant melanoma) Electronic (direct patient entry) 70/80 All visits
    Quebec All Electronic (direct patient entry) 2/92 At every physician visit
    New Brunswick  —  — — —
    Nova Scotia All Paper 9/11 Newly diagnosed patients and at specific transition points in cancer care
    Prince Edward Island All Paper 2/2
    • New patient oncology visits
    • Intravenous chemotherapy review appointments
    • End of treatment for all patients
    Newfoundland & Labrador  All Electronic (tertiary cancer treatment centre);
    paper (with electronic re-entry for all other clinics)
    13/17
    • New patient oncology visits
    • Some follow-up screening at identified points in treatment trajectory

    “—” Data not available

    ‡ All provinces that have implemented Patient Reported Outcomes tools (except BC) were a part of the Patient Reported Outcomes Initiative, led by the Canadian Partnership Against Cancer

    ESAS-r= Edmonton Symptom Assessment System – revised

    Data source: BC Cancer; Patient-Reported Outcomes Initiative Partners

    View this indicator
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