Rural and Urban patients' Requirements and Experiences of Out-of-hours medical care after cancer (RUREO): a questionnaire study

To investigate how individuals diagnosed with cancer use out-of-hours (OOH) medical services, describe the behavioural determinants of OOH service use and explore whether there are differences between urban and rural dwellers. A cross-sectional questionnaire study conducted in Northeast Scotland. Th...

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Bibliographic Details
Published in:	BMJ open 2023-07, Vol.13 (7), p.e073392-e073392
Main Authors:	Duncan, Lisa, Murchie, Peter, Khor, Wei Lynn, Fielding, Shona, Evans, Jillian, Adam, Rosalind
Format:	Article
Language:	eng
Subjects:	After-Hours Care Attitude Caregivers Cross-Sectional Studies Demographics Emergency medical care Health care Health Services Accessibility Health Services Research Humans Medical diagnosis Medical records Neoplasms - therapy Patients Primary care Qualitative research Questionnaires Response rates Rural areas Skin cancer State Medicine Surveys and Questionnaires
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Summary:	To investigate how individuals diagnosed with cancer use out-of-hours (OOH) medical services, describe the behavioural determinants of OOH service use and explore whether there are differences between urban and rural dwellers. A cross-sectional questionnaire study conducted in Northeast Scotland. The questionnaire was sent to 2549 individuals diagnosed with cancer in the preceding 12 months identified through the National Health Service Grampian Cancer Care Pathway database. 490 individuals returned the questionnaire (19.2% response rate), 61.8% were urban and 34.9% were rural. Outcomes were differences in frequency of medical service use and attitudes towards OOH services between urban and rural participants. Patient experience (qualitative data) was compared. Daytime services were used much more frequently than OOH services-83.3% of participants had never contacted an OOH primary care service in the preceding 12 months but 44.2% had used their daytime general practitioner at least four times. There were no significant differences between urban and rural dwellers in the patterns of OOH or daytime service use, the behavioural determinants of service use or the experiences of OOH services. Rural dwellers were significantly less likely to agree that OOH services were close by and more likely to agree that where they lived made it difficult to access these services. Rural dwellers were no more likely to agree or disagree that distance would affect their decision to contact OOH services. Qualitative results highlighted barriers to accessing OOH services exist for all patients but that long travel distances can be offset by service configuration, travel infrastructure and access to a car. Urban and rural dwellers have similar beliefs, attitudes towards and patterns of OOH service use. In Northeast Scotland, place of residence is unlikely to be the most important factor in influencing decisions about whether to access OOH medical care.
ISSN:	2044-6055