Personalized Risk-Stratified Cancer Follow-Up Care: Its Potential for Healthier Survivors, Happier Clinicians, and Lower Costs
Personalized Risk-Stratified Cancer Follow-Up Care: Its Potential for Healthier Survivors, Happier Clinicians, and Lower Costs
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DOI：
10.1093/jnci/djy232
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发表时间：
2019-05-01
影响因子：
10.3
通讯作者：
Alfano, Catherine M.
中科院分区：
文献类型：
--
作者：
Mayer, Deborah K.;Alfano, Catherine M.
面对预计的医疗保健劳动力短缺，癌症幸存者人数的增长将对美国医疗保健系统提供后续护理提出挑战。需要新的提供后续护理的方法来满足幸存者的持续需求，而不会使已经人满为患的肿瘤诊所不堪重负，也不会将所有后续患者送往初级保健提供者。十多年来提出的一个潜在解决方案是采用个性化的护理方法，根据幸存者需求的复杂性和护理所需的提供者类型，对幸存者进行分类或风险分层，采用不同的护理途径。尽管可能会出现其他方法，但我们主张开发、测试和实施风险分层方法作为解决此问题的手段。本评论回顾了在美国提供幸存者护理时转向风险分层方法所需的内容。
The growth in the number of cancer survivors in the face of projected health-care workforce shortages will challenge the US health-care system in delivering follow-up care. New methods of delivering follow-up care are needed that address the ongoing needs of survivors without overwhelming already overflowing oncology clinics or shuttling all follow-up patients to primary care providers. One potential solution, proposed for over a decade, lies in adopting a personalized approach to care in which survivors are triaged or risk-stratified to distinct care pathways based on the complexity of their needs and the types of providers their care requires. Although other approaches may emerge, we advocate for development, testing, and implementation of a risk-stratified approach as a means to address this problem. This commentary reviews what is needed to shift to a risk-stratified approach in delivering survivorship care in the United States.