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基于全州人群数据库的流域地区和癌症人群健康研究:一项范围综述。

Catchment area and cancer population health research through a novel population-based statewide database: a scoping review.

机构信息

Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.

Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.

出版信息

JNCI Cancer Spectr. 2024 Sep 2;8(5). doi: 10.1093/jncics/pkae066.

Abstract

BACKGROUND

Population-based linked datasets are vital to generate catchment area and population health research. The novel Cancer Information and Population Health Resource (CIPHR) links statewide cancer registry data, public and private insurance claims, and provider- and area-level data, representing more than 80% of North Carolina's large, diverse population of individuals diagnosed with cancer. This scoping review of articles that used CIPHR data characterizes the breadth of research generated and identifies further opportunities for population-based health research.

METHODS

Articles published between January 2012 and August 2023 were categorized by cancer site and outcomes examined across the care continuum. Statistically significant associations between patient-, provider-, system-, and policy-level factors and outcomes were summarized.

RESULTS

Among 51 articles, 42 reported results across 23 unique cancer sites and 13 aggregated across multiple sites. The most common outcomes examined were treatment initiation and/or adherence (n = 14), mortality or survival (n = 9), and health-care resource utilization (n = 9). Few articles focused on cancer recurrence (n = 1) or distance to care (n = 1) as outcomes. Many articles discussed racial, ethnic, geographic, and socioeconomic inequities in care.

CONCLUSIONS

These findings demonstrate the value of robust, longitudinal, linked, population-based databases to facilitate catchment area and population health research aimed at elucidating cancer risk factors, outcomes, care delivery trends, and inequities that warrant intervention and policy attention. Lessons learned from years of analytics using CIPHR highlight opportunities to explore less frequently studied cancers and outcomes, motivate equity-focused interventions, and inform development of similar resources.

摘要

背景

基于人群的关联数据集对于生成流域和人口健康研究至关重要。新型的癌症信息和人口健康资源(CIPHR)链接了全州的癌症登记数据、公共和私人保险索赔以及提供者和区域数据,代表了北卡罗来纳州 80%以上的患有癌症的个体的大型、多样化人群。这项对使用 CIPHR 数据的文章进行的范围性综述描述了生成的研究广度,并确定了进一步进行基于人群的健康研究的机会。

方法

在 2012 年 1 月至 2023 年 8 月期间发表的文章根据癌症部位和整个护理连续体中检查的结果进行分类。总结了患者、提供者、系统和政策层面因素与结果之间的统计学显著关联。

结果

在 51 篇文章中,42 篇报告了 23 个独特癌症部位和 13 个跨多个部位的结果。检查的最常见结果是治疗开始和/或依从性(n=14)、死亡率或生存率(n=9)和医疗保健资源利用(n=9)。很少有文章关注癌症复发(n=1)或治疗距离(n=1)作为结果。许多文章讨论了护理中的种族、民族、地理和社会经济不平等。

结论

这些发现表明,稳健、纵向、关联、基于人群的数据库具有很高的价值,可以促进流域和人口健康研究,旨在阐明癌症的风险因素、结果、护理提供趋势以及需要干预和政策关注的不平等现象。利用 CIPHR 进行多年分析的经验教训突出了探索研究较少的癌症和结果、激励以公平为重点的干预措施以及为类似资源的开发提供信息的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5277/11410196/b0d306716016/pkae066f1.jpg

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