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为服务不足的神经肿瘤学人群提供公平的护理。

Delivering Equitable Care to Underserved Neuro-oncology Populations.

机构信息

Mayo Clinic, Phoenix, AZ.

Dana-Farber Cancer Institute, Boston, MA.

出版信息

Am Soc Clin Oncol Educ Book. 2021 Mar;41:1-9. doi: 10.1200/EDBK_320803.

Abstract

It is widely recognized that subspecialized multidisciplinary care improves neuro-oncology outcomes. Optimizing patient outcomes relies on the expertise of the treating physicians, neuroradiology and neuropathology, and supportive services familiar with common neurologic syndromes that occur after brain tumor diagnosis and treatment. Despite an increasing number of providers, patient access to specialized multidisciplinary care and clinical trials remains limited. Barriers to equitable health care exist across the United States, with marginalized communities being impacted disproportionately. Such disparity causes increased morbidity and mortality for patients from backgrounds with various elements of diversity. Limited attention to this inequity has resulted in an incomplete understanding of the spectrum of experiences that patients with neuro-oncologic diseases encounter. Clinical trials represent the highest standard and quality of care in medicine, but inclusion of under-represented and underserved groups consistently lags behind counterpart participants from majority racial and ethnic groups. Through provider education as it pertains to issues from bias and health literacy to increasing clinical trial enrollment and offering opportunities through telemedicine, opportunities for improving access to high-quality neuro-oncologic care are explored.

摘要

广泛认为,专业化的多学科护理可改善神经肿瘤学的治疗效果。为了优化患者的治疗效果,需要依靠主治医生、神经放射科和神经病理学以及支持服务方面的专业知识,这些专业知识需要熟悉在脑肿瘤诊断和治疗后常见的神经综合征。尽管提供的服务越来越多,但患者获得专业的多学科护理和临床试验的机会仍然有限。在美国,公平的医疗保健存在障碍,边缘化社区受到的影响不成比例。这种差异导致来自不同背景的患者的发病率和死亡率增加,这些背景包括多样性的各个方面。对这种不公平现象的关注有限,导致人们对神经肿瘤患者所经历的各种情况的认识不够全面。临床试验代表了医学中最高的标准和护理质量,但代表性不足和服务不足的群体的参与度始终落后于来自多数种族和族裔群体的对照组参与者。通过针对从偏见和健康素养到增加临床试验参与度以及通过远程医疗提供机会等问题的提供者教育,可以探索改善获得高质量神经肿瘤护理的机会。

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