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癌症治疗及时性:从诊断到治疗的比较——乳腺癌、结肠癌、直肠癌和肺癌患者的比较。

Timeliness of cancer care from diagnosis to treatment: a comparison between patients with breast, colon, rectal or lung cancer.

机构信息

Cancer Care, Alberta Health Services, Edmonton, Alberta, Canada.

出版信息

Int J Qual Health Care. 2013 Apr;25(2):197-204. doi: 10.1093/intqhc/mzt003. Epub 2013 Jan 23.

Abstract

OBJECTIVE

The purpose of this study was to assess the value in measuring specific time intervals across cancer sites to identify potentially important variation in the timeliness of cancer care that may inform needed changes and/or improvements in coordination of care.

DESIGN

Retrospective population-level study. Demographic and treatment information were obtained from the Alberta Cancer Registry. Date of oncologist-consult was obtained from cancer medical records.

SETTING

Alberta, Canada.

PARTICIPANTS

All patients diagnosed in 2005 with breast, colon, rectal or lung cancer who were residents of Alberta, Canada.

MAIN OUTCOME MEASURES

(i) Number of days from diagnosis to first treatment by treatment modality and cancer site, (ii) number of days from surgery to post-surgery consultation and subsequent treatment and (iii) relationship between clinical and demographic factors and the cancer-specific provincial median time for outcome measures (i) and (ii).

RESULTS

Time from diagnosis to surgery, if first treatment, was ∼4 months for lung cancer compared with 1-2 months for breast and colorectal cancers. Factors associated with this time interval for breast and colorectal cancers was stage at diagnosis but was region of residence for lung cancer.

CONCLUSIONS

Important variation within and across cancer sites identified in the care intervals evaluated in this study provides relevant information to inform local areas for improvement. Comparisons of these intervals across healthcare systems may also provide insights into strengths of different models for coordinating care.

摘要

目的

本研究旨在评估在不同癌症部位测量特定时间间隔的价值,以确定癌症护理及时性方面可能存在的重要差异,这些差异可能为协调护理方面的改进提供信息。

设计

回顾性人群水平研究。人口统计学和治疗信息从艾伯塔癌症登记处获得。肿瘤学家咨询的日期从癌症病历中获得。

地点

加拿大艾伯塔省。

参与者

2005 年在加拿大艾伯塔省被诊断患有乳腺癌、结肠癌、直肠癌或肺癌的所有患者。

主要观察指标

(i)按治疗方式和癌症部位从诊断到首次治疗的天数,(ii)从手术到术后咨询和随后治疗的天数,以及 (iii)临床和人口统计学因素与癌症特异性省级中位数时间的关系用于衡量 (i) 和 (ii)。

结果

如果首次治疗是手术,那么肺癌从诊断到手术的时间约为 4 个月,而乳腺癌和结直肠癌为 1-2 个月。与乳腺癌和结直肠癌的这个时间间隔相关的因素是诊断时的阶段,但与肺癌的居住地区域相关。

结论

本研究评估的护理间隔内和跨癌症部位的重要差异提供了相关信息,为改进提供了信息。在不同医疗保健系统之间比较这些间隔也可以深入了解不同协调护理模式的优势。

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