Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health.
School of Nursing, UNC Lineberger Comprehensive Cancer Center, University of North Carolina.
J Natl Cancer Inst. 2019 May 1;111(5):442-448. doi: 10.1093/jnci/djy232.
The growth in the number of cancer survivors in the face of projected health-care workforce shortages will challenge the US health-care system in delivering follow-up care. New methods of delivering follow-up care are needed that address the ongoing needs of survivors without overwhelming already overflowing oncology clinics or shuttling all follow-up patients to primary care providers. One potential solution, proposed for over a decade, lies in adopting a personalized approach to care in which survivors are triaged or risk-stratified to distinct care pathways based on the complexity of their needs and the types of providers their care requires. Although other approaches may emerge, we advocate for development, testing, and implementation of a risk-stratified approach as a means to address this problem. This commentary reviews what is needed to shift to a risk-stratified approach in delivering survivorship care in the United States.
面对预计的医疗保健劳动力短缺,癌症幸存者人数的增加将给美国的医疗保健系统在提供后续护理方面带来挑战。需要新的后续护理方法,这些方法需要满足幸存者的持续需求,而不会使已经人满为患的肿瘤诊所不堪重负,也不会将所有后续患者转介给初级保健提供者。十多年来,人们提出了一个潜在的解决方案,即采用个性化的护理方法,根据幸存者的需求复杂性和所需护理提供者的类型,对他们进行分诊或风险分层,以进入不同的护理途径。尽管可能会出现其他方法,但我们主张开发、测试和实施风险分层方法,以此来解决这个问题。本评论回顾了在美国提供生存者护理方面向风险分层方法转变所需的条件。