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社区卫生中心癌症筛查与随访的慢性病照护模式实施

Chronic Care Model implementation for cancer screening and follow-up in community health centers.

作者信息

Haggstrom David A, Taplin Stephen H, Monahan Patrick, Clauser Steven

机构信息

Richard L. Roudebush VA Medical Center, 1481 West 10th Street (11H), Indianapolis, IN 46202, USA.

出版信息

J Health Care Poor Underserved. 2012 Aug;23(3 Suppl):49-66. doi: 10.1353/hpu.2012.0131.

Abstract

BACKGROUND

The Health Disparities Cancer Collaborative (HDCC) implemented six components of the Chronic Care Model (CCM) to increase cancer screening and follow-up among underserved populations from 2003-05.

METHODS

Organizational surveys were administered among 19 community health centers participating in the HDCC and 22 matched control centers. Health care providers, directors, financial officers, information systems personnel, and general staff completed surveys to measure CCM implementation (primary outcome) and cancer care process improvement (secondary outcome) at the organizational level.

RESULTS

The HDCC community health centers were more likely to report CCM implementation than control centers. The HDCC and control centers were equally likely to report cancer care process improvement, but CCM implementation was significantly associated with process improvement in adjusted models.

CONCLUSIONS

Implementation of CCM, not solely HDCC participation, was associated with cancer care process improvement. Organizational and individual change is challenging among the large, healthy populations eligible for cancer screening.

摘要

背景

健康差异癌症协作组织(HDCC)在2003年至2005年期间实施了慢性病护理模式(CCM)的六个组成部分,以增加服务不足人群的癌症筛查和后续跟进。

方法

对参与HDCC的19个社区卫生中心和22个匹配的对照中心进行了组织调查。医疗保健提供者、主任、财务人员、信息系统人员和普通员工完成了调查,以衡量组织层面的CCM实施情况(主要结果)和癌症护理流程改进情况(次要结果)。

结果

与对照中心相比,HDCC社区卫生中心更有可能报告CCM的实施情况。HDCC和对照中心报告癌症护理流程改进的可能性相同,但在调整模型中,CCM的实施与流程改进显著相关。

结论

CCM的实施,而非仅仅是参与HDCC,与癌症护理流程改进相关。在符合癌症筛查条件的大量健康人群中,组织和个人的改变具有挑战性。

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