Abstract
Radiation therapy, an essential treatment for cancer, has been concerned over the recent years due to its enormous investment in both high technology medical devices and various specialists. Anecdotal observation found inappropriate distribution of radiation therapy resources across the country which led to inefficient use of health care resources and possibly under-standard treatment in some radiation therapy units (RTUs). A lack of evidence-based planning on health care services is supposed to be the major cause. Thus, this study aims to demonstrate the current situation of radiation therapy comparing with expressed health needs and access to radiation therapy services of cancer patients. This will bring about the policy recommendations on how to invest and distribute health care resources according to health needs. The goal of this study is to improve efficiency of health resource utilization and equitable access to health services by using radiation therapy as the case study. Both quantitative and qualitative methods were employed in this research. A census of 25 RTUs and 72 radiation therapists were conducted. Cancer patients and some radiation therapists were interviewed by using semi-structured questionnaires. Moreover, document and content analysis were also used.The results reveal that lacking of human resources, both radiation therapists and medical physicists, are more serious problems of the MOPH radiation therapy services than the shortage of radiation therapy devices. The finding illustrates that no radiation therapy unit of MOPH passes the minimal standard amount of radiation therapists, whilst only 20% of them passes the minimal standard amount of medical physicists. Moreover, access to radiation therapy services are inequitable among cancer patients. Cancer patients in remote provinces tend to have poorer access to health care than those in RTUs neighboring provinces. Factors influencing not access to radiation therapy services are physical barriers, and financial barriers in terms of medical care costs and transportation expenditure. For socio-economic status, most cancer patients are the elderly and poor without doing any jobs. Quality improvement on radiation therapy services as well as adequate vital human resources (radiation therapists and medical physicists) are urgent issues which the MOPH has to solve. In the long run, the national plan of radiation therapy system which determines the amount, proportion and distribution of principle, advanced, and excellent radiation therapy centers have to be made. For improving access to care, the improvement of health insurance coverage and the provisions of financial support for transportation are better policy than investment in the new radiation therapy units.
