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社会决定因素、劳动力多样性和财务毒性:癌症护理差异的综述。

Social determinants of health, workforce diversity, and financial toxicity: A review of disparities in cancer care.

机构信息

Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI.

Geisel School of Medicine, Dartmouth College, Hanover, NH.

出版信息

Curr Probl Cancer. 2022 Oct;46(5):100893. doi: 10.1016/j.currproblcancer.2022.100893. Epub 2022 Aug 6.

Abstract

Disparities in cancer care and outcomes between racial and ethnic groups, urban and rural populations, and socioeconomic classes are well documented and represent one of the greatest forms of injustice throughout the United States. Despite the development of increasingly efficacious treatments, survival disparities have widened over time, with known impacts based on both medical factors and social determinants of health including education, neighborhood, factors, and access to care, among others. In this review, we discuss current state of inequities in access to cancer services, treatment-related financial toxicity, and disparities within the oncology workforce, all of which significantly impact the ability of clinicians to provide high quality, equitable, and guideline-compliant care for all people with cancer.

摘要

癌症护理和结局在不同种族和族裔群体、城乡人口以及社会经济阶层之间的差异有充分的记录,这是美国最大的不公正形式之一。尽管治疗效果越来越好,但随着时间的推移,生存差距仍在扩大,已知的影响不仅基于医疗因素,还基于健康的社会决定因素,包括教育、邻里、因素和获得医疗保健的机会等。在这篇综述中,我们讨论了癌症服务获取、与治疗相关的经济毒性以及肿瘤学劳动力内部的差异方面目前存在的不平等现象,这些都严重影响了临床医生为所有癌症患者提供高质量、公平和符合指南的护理的能力。

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