Minimizing the burden of cancer in the United States: Goals for a high-performing health care system
Minimizing the burden of cancer in the United States: Goals for a high-performing health care system
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DOI：
10.3322/caac.21556
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发表时间：
2019-05-01
影响因子：
254.7
通讯作者：
Brawley, Otis W.
中科院分区：
文献类型：
--
作者：
Yabroff, K. Robin;Gansler, Ted;Brawley, Otis W.
在1991年至2015年期间，美国的癌症死亡率大幅下降，反映了癌症预防，筛查，治疗和生存护理的改善。然而，美国的癌症结果在由种族/民族、社会经济地位、健康保险覆盖范围和居住地理区域定义的人群之间存在很大差异。许多潜在可预防的癌症死亡发生在没有接受有效癌症预防，筛查，治疗或生存护理的个体中。与此同时，癌症护理支出庞大且不断增长，使国家，州，健康保险计划和家庭预算紧张。事实上，美国医学界最紧迫的问题之一是如何确保每个社区的所有人口都能从已经完成的科学研究中获益。从卫生保健提供的角度解决这些问题是必要的，以加速从1990年代初开始的癌症死亡率下降。这篇文章是癌症控制蓝图系列的一部分，描述了在美国癌症控制连续体中提供护理的挑战。它还确定了建立一个高效卫生系统的目标，通过促进采用健康的生活方式，减少差异和癌症负担;获得定期初级保健;及时获得循证护理;以病人为中心，包括病人与提供者的有效沟通;加强提供者之间的协调和沟通，包括初级保健和专科保健提供者;以及患者、付款人和社会的可负担性。
Between 1991 and 2015, the cancer mortality rate declined dramatically in the United States, reflecting improvements in cancer prevention, screening, treatment, and survivorship care. However, cancer outcomes in the United States vary substantially between populations defined by race/ethnicity, socioeconomic status, health insurance coverage, and geographic area of residence. Many potentially preventable cancer deaths occur in individuals who did not receive effective cancer prevention, screening, treatment, or survivorship care. At the same time, cancer care spending is large and growing, straining national, state, health insurance plans, and family budgets. Indeed, one of the most pressing issues in American medicine is how to ensure that all populations, in every community, derive the benefit from scientific research that has already been completed. Addressing these questions from the perspective of health care delivery is necessary to accelerate the decline in cancer mortality that began in the early 1990s. This article, part of the Cancer Control Blueprint series, describes challenges with the provision of care across the cancer control continuum in the United States. It also identifies goals for a high-performing health system that could reduce disparities and the burden of cancer by promoting the adoption of healthy lifestyles; access to a regular source of primary care; timely access to evidence-based care; patient-centeredness, including effective patient-provider communication; enhanced coordination and communication between providers, including primary care and specialty care providers; and affordability for patients, payers, and society.