All.Can Patient Survey

18 The past decade has seen transformational advances in cancer care. As the prevalence of cancer increases, governments and health systems around the world are struggling to fund these advances – and notions of value, efficiency and affordability have become increasingly important in the cancer policy debate. At least one fifth of total healthcare spending is thought to be wasted on inefficient care. 9 Moreover, removing wasteful or ineffective interventions could lead to a gain of approximately two years of life expectancy in industrialised countries. 10 Within this landscape, leading researchers and policy experts are trying to identify where inefficiencies lie, in order to pave the way for sustainable cancer care. 11-13 Unfortunately, the patient perspective is too often forgotten in current definitions of value and efficiency. 14 Existing definitions are most often driven by health economists and healthcare professionals, with outcomes measures often based on processes that are easily measurable within healthcare systems, rather than on outcomes known to matter to patients. 14 15 Yet patients are, arguably, the only people who have full sight of the impact of their condition and care experience on their physical, emotional and mental wellbeing. 14 Their perspectives must, therefore, be built into any definitions of value and efficiency. All.Can defines inefficiency as the allocation of resources to anything that does not focus on what matters to patients. 16 Our aim is to find sustainable solutions to improving cancer care. To guide these efforts, we need to gain a better understanding of where patients perceive their care is not focused on what matters to them – and find practical ways to remedy any gaps. The All.Can patient survey was designed with this purpose in mind: we asked patients where they had encountered inefficiencies in their care, and where efforts were most needed to improve efficiency. We made our definition of inefficiency explicit throughout the survey. This report presents the main themes that have emerged from our findings. While most respondents reported that their needs were sufficiently addressed, the findings also show that there is clear room for improvement. Each of the themes represents an opportunity for improving cancer care from the perspective of patients. Nearly 4,000 respondents frommore than 10 countries participated in the survey – making this, to our knowledge, the largest international survey specifically aimed at obtaining patient perspectives on inefficiency in cancer care. It is our hope that the insights gathered in this report may help guide patient-driven policies to improve the efficiency and sustainability of cancer care. Introduction