Availability and Integration of Palliative Care at US Cancer Centers
Availability and Integration of Palliative Care at US Cancer Centers
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DOI：
10.1001/jama.2010.258
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发表时间：
2010-03-17
影响因子：
120.7
通讯作者：
Bruera, Eduardo
中科院分区：
文献类型：
--
作者：
Hui, David;Elsayem, Ahmed;Bruera, Eduardo
背景癌症中心姑息治疗的现状尚不清楚。目的确定姑息治疗服务的可用性和整合程度，并在美国国家癌症研究所（NCI）和非NCI癌症中心之间进行比较。一项对71个国家癌症研究所指定的癌症中心和71个非癌症中心的随机样本的调查，2009年6月至10月期间，NCI癌症中心主管和姑息治疗临床项目负责人（如适用）关于其姑息治疗服务的信息。调查问题是在全面的文献检索、对国家质量论坛指南的审查以及7名对姑息肿瘤学有研究兴趣的医生的讨论后产生的。行政人员也被问到他们的态度对palliative care.Main结果测量的姑息治疗服务的癌症中心，定义为至少有1姑息治疗physician.Results的存在，共142和120调查发送给行政人员和项目负责人，响应率分别为71%和82%。国家癌症研究所癌症中心更有可能有姑息治疗计划（50/51 [98%] vs 39/50 [78%]; P=.002），至少有1名姑息治疗医生（46/50 [92%] vs 28/38 [74%]; P=.04），住院姑息治疗咨询团队（47/51 [92%] vs 28/50 [56%]; P
Context The current state of palliative care in cancer centers is not known.Objectives To determine the availability and degree of integration of palliative care services and to compare between National Cancer Institute (NCI) and non-NCI cancer centers in the United States.Design, Setting, and Participants A survey of 71 NCI-designated cancer centers and a random sample of 71 non-NCI cancer centers of both executives and palliative care clinical program leaders, where applicable, regarding their palliative care services between June and October 2009. Survey questions were generated after a comprehensive literature search, review of guidelines from the National Quality Forum, and discussions among 7 physicians with research interest in palliative oncology. Executives were also asked about their attitudes toward palliative care.Main Outcome Measure Availability of palliative care services in the cancer center, defined as the presence of at least 1 palliative care physician.Results A total of 142 and 120 surveys were sent to executives and program leaders, with response rates of 71% and 82%, respectively. National Cancer Institute cancer centers were significantly more likely to have a palliative care program (50/51 [98%] vs 39/50 [78%]; P=.002), at least 1 palliative care physician (46/50 [92%] vs 28/38 [74%]; P=.04), an inpatient palliative care consultation team (47/51 [92%] vs 28/50 [56%]; P