Health system performance and outcomes for Indigenous Australians with cancer: a national study.

癌症直到最近才被认识到是一个重要的土著健康问题，部分原因是没有关于癌症对土著人民的影响或对土著癌症患者的卫生系统绩效的全国性信息。最近在北领地进行的研究表明，与其他癌症患者相比，土著人在诊断、治疗和生存方面存在很大缺陷。尽管关于土著地位的数据不完善，但可以从国家行政数据库和登记册中获得关于土著澳大利亚人卫生系统绩效的重要信息。该项目将首次在国家一级评估卫生系统对土著癌症患者的绩效和结果。它将比较整个澳大利亚土著居民与非土著居民的癌症存活率，包括地区（城市-农村-偏远地区）差异和时间趋势。对于那些有诊断和住院治疗阶段数据的州，它还将通过比较土著癌症患者的诊断和手术治疗阶段与非土著癌症患者的诊断和手术治疗阶段，调查土著癌症患者的诊断和治疗服务的表现。将利用过去10-15年具有足够质量和一致性数据的各州的数据来审查这些问题的时间趋势。该项目将为在国家癌症报告系统中定期报告土著癌症存活率和相关统计数据提供方法学基础，并证明在其他情况下对土著人民的急症护理系统进行国家监测是可能的。这项研究的结果将直接为土著癌症患者的急性护理政策和实践提供信息（特别是改善初级卫生保健或急性护理服务的相对需要），并对澳大利亚土著居民的急性护理系统系统的表现产生影响。

Cancer has only recently been recognised as a significant Indigenous health issue, partly because no national information has been available on the impact of cancer on Indigenous people or on health system performance for Indigenous cancer patients. Recent research in the Northern Territory has demonstrated large deficiencies in diagnosis, treatment and survival for Indigenous compared to other cancer patients. Despite imperfect data on Indigenous status, important information can be obtained about health system performance for Indigenous Australians from national administrative databases and registers. This project will assess health system performance and outcome for Indigenous people with cancer at a national level for the first time. It will compare Indigenous with non-Indigenous cancer survival rates for Australia as a whole, including regional (urban-rural-remote) variations and time trends. For those states where data on stage at diagnosis and hospital treatment are available, it will also investigate the performance of diagnostic and treatment services for Indigenous cancer patients by comparing their stage at diagnosis and surgical treatment with that for non-Indigenous patients. Time trends for each of these issues will be examined using data from those states with data of adequate quality and consistency over the past 10-15 years. This project will provide the methodological basis for regular reporting of Indigenous cancer survival and related statistics in the national cancer reporting system and demonstrate that national monitoring of the acute care system for Indigenous people is possible for other conditions. The results of this research will directly inform acute care policy and practice for Indigenous people with cancer (particularly the relative need for improvement in primary health or acute care services), and have implications for the performance of the acute care system system more generally for Indigenous Australians.