DETERMINANTS OF ACCESS TO PEDIATRIC CANCER CARE

获得儿科癌症护理的决定因素

• 批准号: 2099782
• 负责人: BRAD H POLLOCK
• 金额: $ 3.62万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-06-15 至 1995-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2099782
• 关键词: cancer registry /resource; cancer rehabilitation /care; child (0-11); choice; community health services; decision making; health care service evaluation; health care service utilization; health surveys; hospital utilization; human subject; parents; patient care management; pediatric neoplasm /cancer; physicians; statistics /biometry

State-of-the-art therapy for childhood cancer requires access to highly coordinated delivery of care and a multidisciplinary approach of specialized pediatric cancer programs. The experience of specialists at cancer centers and their access to therapeutic protocols enables state- of-the-art treatments to be tailored to the needs of pediatric patients, and such treatment has been shown to improve patient results. Prior studies have indicated that when pediatric patients are treated outside of this specialized care setting, there are qualitative differences in their care and outcome. Data from the State of Florida indicate that 19% of children with cancer are never seen at a cancer center, despite the efforts of the three university-based pediatric cancer programs (and two affiliated programs) and the Florida Pediatric CCOP, which extend state- of-the-art therapies to seven community hospitals in Florida. To reduce morbidity and mortality due to pediatric cancer, further interventions based on cancer control research studies in community oncology must be designed and utilized to impact this population and enhance the utilization of existing cancer expertise. The specific aim of the proposed study is to identify the factors that affect the decision by the community physician and patient/parent of where to seek care for a child with cancer, whether at a pediatric cancer center (PCC) or a non-cancer center (NCC), and to design interventions to impact on this decision. Children will be classified by whether they were treated at a PCC (control) or not (case). These data will be analyzed as a nested case-control study to allow formulation of hypotheses that might directly lead to community oncology interventions and to improving such as the application of patient management and continuing care research advances into community settings, which is the long range goal of this research. This study has particular strength in that the proposed Study Center has extensive experience in conducting multi-institutional studies, and maintains close affiliations with both of the Florida cancer registries. Through access to the registries, the Study Center tracks approximately 400 patients newly diagnosed each year with pediatric cancers and monitors transfers and referrals from non-pediatric cancer programs so that children with cancer can be characterized as receiving care at a pediatric cancer center (PCC) or not (NCC). By conducting this study, appropriate interventions can be targeted directly to treating physicians and patients/parents so that state-of-the-art cancer care can be made available to all children with cancer in Florida.

儿童癌症的最新疗法需要高度使用 协调的护理交付和多学科的方法 专门的小儿癌症计划。 专家的经验 癌症中心及其获得治疗方案的机会使国家 - 根据儿科患者的需求量身定制的艺术治疗 这种治疗已被证明可以改善患者的结果。 事先的 研究表明，当小儿患者在外面治疗时 在这个专业的护理环境中，存在定性差异 他们的关心和结果。 来自佛罗里达州的数据表明19％ 尽管有 三个基于大学的儿科癌症计划的努力（和两个 附属计划）和佛罗里达州的儿科CCOP，这些CCOP扩展了州 佛罗里达州七家社区医院的疗法。 减少 小儿癌引起的发病率和死亡率，进一步的干预措施 基于癌症控制研究，社区肿瘤学必须是 设计和使用来影响该人群，并增强 现有癌症专业知识的利用。 拟议研究的具体目的是确定 影响社区医师和患者/父母的决定 无论在儿科癌症中，在哪里寻找癌症儿童 中心（PCC）或非癌症中心（NCC），并设计干预措施 影响这一决定。 孩子是否会因他们是否是否 在PCC（对照）是否（案例）进行处理。 这些数据将是 被分析为嵌套的病例对照研究，以允许制定 可能直接导致社区肿瘤干预的假设 并改善诸如患者管理的应用和 持续护理研究发展到社区环境，这是 这项研究的远程目标。 这项研究具有特殊的优势，因为拟议的研究中心具有 在进行多机构研究方面的丰富经验， 与佛罗里达癌症登记处保持密切关系。 通过进入注册表，研究中心大约跟踪 每年有400名新诊断的儿科癌症患者 监视非培养癌症计划的转移和转介，因此 癌症的儿童可以被描述为在 儿科癌症中心（PCC）是否（NCC）。 通过进行这项研究， 适当的干预措施可以直接针对治疗医生 和患者/父母，可以进行最先进的癌症护理 可用于佛罗里达州所有癌症儿童。