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社区癌症护理中的共置模式:患者临床和人口统计学特征及转诊途径的描述。

The Colocation Model in Community Cancer Care: A Description of Patient Clinical and Demographic Attributes and Referral Pathways.

机构信息

Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.

Charles River Community Health, Waltham, MA.

出版信息

JCO Oncol Pract. 2023 Jun;19(6):e916-e926. doi: 10.1200/OP.22.00487. Epub 2023 Mar 20.

Abstract

PURPOSE

Cancer disparities are well documented among Black, Indigenous, and People of Color, yet little is known about the characteristics of programs that serve these populations. Integrating specialized cancer care services within community settings is important for addressing the needs of historically marginalized populations. Our National Cancer Institute-Designated Cancer Center initiated a clinical outreach program incorporating cancer diagnostic services and patient navigation within a Federally Qualified Health Center (FQHC) to expedite evaluation and resolution of potential cancer diagnoses with the goal of collaboration between oncology specialists and primary care providers in a historically marginalized community in Boston, MA.

MATERIALS AND METHODS

Sociodemographic and clinical characteristics were analyzed from patients who were referred to the program for cancer-related care between January 2012 and July 2018.

RESULTS

The majority of patients self-identified as Black (non-Hispanic) followed by Hispanic (Black and White). Twenty-two percent of patients had a cancer diagnosis. Treatment and surveillance plans were established for those with and without cancer at a median time to diagnostic resolution of 12 and 28 days, respectively. The majority of patients presented with comorbid health conditions. There was a high prevalence of self-reported financial distress among patients seeking care through this program.

CONCLUSION

These findings highlight the wide spectrum of cancer care concerns in historically marginalized communities. This review of the program suggests that integrating cancer evaluation services within community-based primary health care settings offers promise for enhancing the coordination and delivery of cancer diagnostic services among historically marginalized populations and could be a method to address clinical access disparities.

摘要

目的

黑人和原住民以及有色人种之间的癌症差异是有据可查的,但对于服务这些人群的项目的特点却知之甚少。在社区环境中整合专门的癌症护理服务对于满足历史上被边缘化人群的需求非常重要。我们的美国国立癌症研究所指定癌症中心在一家合格的联邦健康中心(FQHC)内启动了一项临床外展计划,将癌症诊断服务和患者导航纳入其中,以加快对潜在癌症诊断的评估和解决,目标是在马萨诸塞州波士顿的一个历史上被边缘化的社区中,肿瘤专家和初级保健提供者之间进行合作。

材料和方法

对 2012 年 1 月至 2018 年 7 月期间因癌症相关护理而被转介到该项目的患者的社会人口统计学和临床特征进行了分析。

结果

大多数患者自我认定为黑人(非西班牙裔),其次是西班牙裔(黑人和白人)。22%的患者有癌症诊断。对于有和没有癌症的患者,分别在中位数时间 12 天和 28 天制定了治疗和监测计划。大多数患者有合并症。通过该项目寻求护理的患者中有很高的财务困境自我报告率。

结论

这些发现强调了历史上被边缘化社区中广泛存在的癌症护理问题。对该项目的审查表明,在基于社区的初级卫生保健机构中整合癌症评估服务为在历史上被边缘化人群中增强癌症诊断服务的协调和提供提供了希望,并且可能是解决临床获得差距的一种方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d7/10332843/f4dd9a36d4e9/op-19-e916-g004.jpg

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