Castro Eida M, Jiménez Julio C, Quinn Gwendolyn, García Myra, Colón Yesenia, Ramos Axel, Brandon Thomas, Simmons Vani, Gwede Clement, Vadaparampil Susan, Nazario Cruz María
Department of Psychology, Ponce School of Medicine and Health Sciences, #388 Zona Industrial Reparada 11, Ponce, 00716, Puerto Rico,
Support Care Cancer. 2015 Apr;23(4):967-75. doi: 10.1007/s00520-014-2451-5. Epub 2014 Sep 24.
The objectives of this study were to identify cancer-related health care services and to explore the presence of inter-organizational interactions among clinical and support oncology services in southern Puerto Rico.
From January through July of 2010, a survey was completed by 54 health care organizations offering clinical, supportive, or both services to cancer patients/survivors (CPS) in southern PR. Survey data were compiled and descriptive analyses performed using the software Statistical Package for a Social Science (SPSS), version 18.0.
The distribution of the primary services provided by the participating organizations was the following: 26 had clinical services, 16 had support services, and 12 offered a combination of clinical and support services. Only 24 % of the surveyed organizations offered their services exclusively to patients diagnosed with cancer. In terms of referral practices, 61 % of the responses were for medical specialists, 43 % were for mental health services, and 37 % were referrals for primary care services. The most common reason for interacting (n = 27) was to provide a given patient both a referral and information.
Findings suggest gaps in both the availability of oncology services and the delivery of integrated health care. Lack of communication among clinical and support organizations (for cancer patients, specifically) could negatively impact the quality of the services that they offer. Further network analysis studies are needed to confirm these gaps. Until systemic, structural changes occur, more efforts are needed to facilitate communication and collaboration among these kinds of organization.
本研究的目的是确定与癌症相关的医疗保健服务，并探索波多黎各南部临床肿瘤服务与支持性肿瘤服务之间组织间互动的存在情况。
2010年1月至7月，54个为波多黎各南部癌症患者/幸存者（CPS）提供临床、支持性或两者兼有的服务的医疗保健组织完成了一项调查。使用社会科学统计软件包（SPSS）18.0版对调查数据进行整理并进行描述性分析。
参与组织提供的主要服务分布如下：26个提供临床服务，16个提供支持服务，12个提供临床和支持服务的组合。只有24%的被调查组织仅为被诊断患有癌症的患者提供服务。在转诊实践方面，61%的回复是转诊给医学专家，43%是转诊给心理健康服务，37%是转诊给初级保健服务。互动的最常见原因（n = 27）是为特定患者提供转诊和信息。
研究结果表明肿瘤服务的可及性和综合医疗保健的提供方面均存在差距。临床组织与支持组织之间（特别是针对癌症患者）缺乏沟通可能会对它们提供的服务质量产生负面影响。需要进一步的网络分析研究来证实这些差距。在系统性的结构变革发生之前，需要做出更多努力来促进这类组织之间的沟通与协作。
