American Society of Clinical Oncology, Alexandria VA; Great Lakes Cancer Management Specialists, Macomb, MI; and University of Chicago, Chicago, IL.
J Oncol Pract. 2018 Jul;14(7):e412-e420. doi: 10.1200/JOP.18.00149. Epub 2018 Jun 15.
To describe the US hematology and medical oncology practice landscape and to report findings of the sixth annual ASCO Oncology Practice Census survey.
ASCO used Medicare Physician Compare data to characterize oncology practices in the United States. Practice size, number of care sites, and geographic distribution were determined. Trends in the number and size of practices from 2013 to 2017 were examined. All US oncology practices were targeted for the survey; survey responses were linked to the practices identified from Physician Compare to augment results and assess generalizability.
More than 2,200 hematology/oncology practices provided care to adult patients in 2017. We observed annual decreases in the number of practices and annual increases in practice size. Of the 2017 practices, 394 (18%) completed the survey and accounted for 58% of the US hematologist/oncologist workforce (n = 7,203). Respondents tended to be larger and encompass more sites of care than nonrespondents. Surveyed practices cited payers (58%), competition (38%), and staffing (37%) as primary sources of strain. Prior authorization was dominant among payer pressures (78%). Electronic health records remained a burden on practices, with only 15% reporting full interoperability.
The results of ASCO's 2017 survey indicate that oncology practices are challenged by day-to-day operations, often related to payment, reimbursement, and competition. Our findings likely represent conservative estimates of such burdens because they are driven by responses from midsized to large-sized organizations, which have lower relative administrative burden, greater market influence, and potentially better ability to adapt in a changing health care environment.
描述美国血液学和肿瘤医学实践情况，并报告第六次年度 ASCO 肿瘤实践普查调查结果。
ASCO 使用 Medicare Physician Compare 数据来描述美国的肿瘤学实践。确定了实践规模、护理站点数量和地理分布。检查了 2013 年至 2017 年实践数量和规模的趋势。调查针对所有美国肿瘤学实践；将调查回复与从 Physician Compare 中确定的实践联系起来，以增强结果并评估普遍性。
2017 年，超过 2200 个血液学/肿瘤学实践为成年患者提供护理。我们观察到实践数量的年度减少和实践规模的年度增加。在 2017 年的实践中，有 394 个（18%）完成了调查，占美国血液学家/肿瘤学家劳动力的 58%（n=7203）。受访者往往比未回复者更大，涵盖更多的护理站点。调查的实践将支付方（58%）、竞争（38%）和人员配备（37%）列为主要压力源。预先授权是支付方压力的主要因素（78%）。电子健康记录仍然是实践的负担，只有 15%报告完全互操作性。
ASCO 2017 年调查的结果表明，肿瘤学实践受到日常运营的挑战，这些挑战通常与支付、报销和竞争有关。我们的研究结果可能代表了这种负担的保守估计，因为它们是由中型到大型组织的回复驱动的，这些组织的相对行政负担较低，市场影响力更大，并且在不断变化的医疗保健环境中可能具有更好的适应能力。
