The Role of Primary Care Physicians in Cancer Care
The Role of Primary Care Physicians in Cancer Care
复制标题
DOI：
10.1007/s11606-009-1058-x
复制
发表时间：
2009-09-01
影响因子：
5.7
通讯作者：
Kahn, Katherine L.
中科院分区：
文献类型：
--
作者：
Klabunde, Carrie N.;Ambs, Anita;Kahn, Katherine L.
背景：美国对肿瘤学服务的需求正在增加，而肿瘤学家的短缺迫在眉睫。有必要更好地了解初级保健医生（PCP）在癌症护理中的参与情况，目的：描述PCP在癌症护理中的作用，将其与肿瘤学家的作用进行比较，并确定解释PCP参与癌症护理的因素。测量：2005年和2006年期间邮寄的问卷调查了医生参与癌症患者护理的12个方面。主要结果：超过90%的PCP履行了癌症患者的一般医疗护理角色，如管理共病状况、慢性疼痛或抑郁症;把病人送到临终关怀中心肿瘤学家较少参与这些角色。确定个体患者的治疗偏好和决定使用手术是>= 50%的PCP参与的唯一癌症护理角色。22%的PCP报告没有直接参与癌症护理角色，而19%的PCP报告严重参与。年龄>= 50岁、内科医生或老年病医生、教医学生、看过更多癌症患者或经历过转诊障碍的PCP扮演更多角色。农村实践的位置是不相关的更大的PCP参与cancercarry.CONCLUSIONS：PCP在美国各地的癌症患者管理中发挥了积极的作用。确定PCP和肿瘤学家在提供和协调癌症护理方面的最佳界面是未来研究的重要领域。
BACKGROUND: The demand for oncology services in the United States (US) is increasing, whereas a shortage of oncologists looms. There is the need for a better understanding of the involvement of primary care physicians (PCPs) in cancer care.OBJECTIVE: To characterize the role of PCPs in cancer care, compare it with that of oncologists, and identify factors explaining greater PCP involvement in cancer care.DESIGN: National survey of physicians caring for cancer patients conducted by the Cancer Care Outcomes Research and Surveillance Consortium.PARTICIPANTS: 1694 PCPs; 1621 oncologists.MEASUREMENTS: Questionnaires mailed during 2005 and 2006 examined the participation of physicians in 12 aspects of care for cancer patients.MAIN RESULTS: Over 90% of PCPs fulfilled general medical care roles for patients with cancer such as managing comorbid conditions, chronic pain, or depression; establishing do-not-resuscitate status; and referring patients to hospice. Oncologists were less involved in these roles. Determining the treatment preferences of individual patients and deciding on the use of surgery were the only cancer care roles in which >= 50% of PCPs participated. Twenty-two percent of PCPs reported no direct involvement in cancer care roles while 19% reported heavy involvement. PCPs who were aged >= 50 years, were internists or geriatricians, taught medical students, saw more cancer patients, or experienced referral barriers fulfilled more roles. Rural practice location was not associated with greater PCP involvement in cancer care.CONCLUSIONS: PCPs across the US have an active role in cancer patient management. Determining the optimal interface between PCPs and oncologists in delivering and coordinating cancer care is an important area for future research.