Planning for radiotherapy services requires information on the proportion of cancer patients who should receive radiotherapy. CCORE has previously estimated optimal rates of radiotherapy utilization (RTU) based on the development of decision trees using evidence-based treatment guidelines and epidemiological data1,2. In Ontario, Mackillop established CBB approach to estimate RTU 3-9.
Radiotherapy data were linked to CCR. Calculate road distances between patient residence and nearest RT. Cross-border patients were excluded. Benchmark criteria are:
Overall, 25.4% of cancer patients received radiotherapy within 1-year of diagnosis in CBB LGAs compared to 22.1% in all LGAs. Actual RTU for NSW, Alberta & USA are comparable but lower than Ontario. CBB RTU rates were > actual RTU but < optimal RTU.
Limitations of the CBB model:
RTU were 7-16% higher in CBB communities than in all communities but are still 30-65% below optimal RTU. CBB is based on the assumption that there is perfect service delivery in some parts of health service that can be used to benchmark the whole service. This approach may be applicable in well-resourced service delivery model in Ontario, but until feasibility is proved applicable in different regions, CBB approach doesn't seem reproducible and may not be recommended for benchmarking RTU. We recommend evidence-based optimal RTU.