Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
Oncologist. 2024 Feb 2;29(2):e290-e293. doi: 10.1093/oncolo/oyad313.
How and where patients with advanced cancer facing limited survival spend their time is critical. Healthcare contact days (days with healthcare contact outside the home) offer a patient-centered and practical measure of how much of a person's life is consumed by healthcare. We retrospectively analyzed contact days among decedent veterans with stage IV gastrointestinal cancer at the Minneapolis Veterans Affairs Healthcare System from 2010 to 2021. Among 468 decedents, the median overall survival was 4 months. Patients spent 1 in 3 days with healthcare contact. Over the course of illness, the percentage of contact days followed a "U-shaped" pattern, with an initial post-diagnosis peak, a lower middle trough, and an eventual rise as patients neared the end-of-life. Contact days varied by clinical factors and by sociodemographics. These data have important implications for improving care delivery, such as through care coordination and communicating expected burdens to and supporting patients and care partners.
晚期癌症患者的生存时间和生存地点至关重要。医疗接触天数（在家外与医疗保健接触的天数）是衡量一个人生命中有多少时间被医疗保健消耗的一种以患者为中心且实用的方法。我们回顾性分析了 2010 年至 2021 年明尼苏达州退伍军人事务部医疗系统中患有 IV 期胃肠道癌症的已故退伍军人的接触天数。在 468 名死者中，中位总生存期为 4 个月。患者有 1/3 的时间与医疗保健接触。在疾病过程中，接触天数呈现出“U 型”模式，在诊断后初期达到峰值，中间较低，随着患者接近生命终点，最终再次上升。接触天数因临床因素和社会人口统计学因素而异。这些数据对改善护理提供具有重要意义，例如通过护理协调以及向患者和护理伙伴传达预期负担并提供支持。
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