Section of Oncology/Hematology, Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
Leuk Lymphoma. 2010 Oct;51(10):1862-9. doi: 10.3109/10428194.2010.510896.
Studies examining follow-up care among cancer survivors have increased in number, and are mostly focused on who best provides care. It is not known whether having single or multiple physicians as follow-up providers has outcome implications. We prospectively studied the association between number of follow-up providers among survivors of hematologic malignancies and serious medical utilization (defined as emergency room visits or hospitalizations) within a 6-month period. Patients completing treatment (n = 314) were included. Patients seeing multiple follow-up providers were more likely to be younger, to reside farther away from the university hospital, to have prescription drug insurance, to have received prior cancer treatment, to have multiple myeloma, and to have undergone hematopoietic cell transplant as a part of cancer treatment. Multivariate analysis showed that the number of follow-up providers was not associated with serious medical utilization (odds ratio 1.29, 95% confidence interval 0.68–2.48, p = 0.44) after adjusting for patient factors. Our study showed that among survivors of hematologic malignancies, outcomes were not different for survivors who were seen by single or multiple follow-up providers.
研究癌症幸存者的随访护理的数量有所增加，且主要集中在谁能最好地提供护理。目前尚不清楚有一位或多位医生作为随访提供者是否会对结果产生影响。我们前瞻性地研究了血液系统恶性肿瘤幸存者的随访提供者数量与 6 个月内严重医疗利用（定义为急诊就诊或住院）之间的关系。纳入了完成治疗的患者（n=314）。与仅看一位随访医生的患者相比，看多位随访医生的患者更年轻，居住的地方离大学医院更远，有处方药保险，曾接受过癌症治疗，患有多发性骨髓瘤，且癌症治疗中接受过造血细胞移植。多变量分析表明，调整患者因素后，随访提供者的数量与严重医疗利用之间无关联（比值比 1.29，95%置信区间 0.68-2.48，p=0.44）。我们的研究表明，在血液系统恶性肿瘤幸存者中，由一位或多位随访提供者提供治疗的患者的结局无差异。
