Improving rural cancer care delivery

改善农村癌症护理服务

• 批准号: 10225979
• 负责人: Izumi Okado
• 金额: $ 6.86万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-09 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10225979
• 关键词: Improving; rural; cancer; care; delivery

Project Summary/Abstract Although advances in cancer treatment have improved patient survival overall, cancer mortality rates in rural populations remain disproportionately higher than urban populations. Rural-urban disparities in cancer mortality rates are thought to, in part, reflect suboptimal care coordination in rural areas. Cancer patients residing in rural areas experience greater care coordination challenges including limited or lack of access to medical care, travel burdens, shortages of specialists, and delays in receiving diagnosis and post-diagnosis intervention. Delays in diagnosis and treatment initiation have been shown to adversely impact patient survival; such delays have been associated with a three-fold cancer mortality risk. However, little is known about rural cancer patients’ perception of care coordination, rural-urban differences in specific cancer care coordination processes, and the impact of rural cancer care coordination on specific care delivery outcomes. The proposed research will address these knowledge gaps and accomplish the following aims: Aim 1) To compare rural and urban cancer patients’ perception of care coordination and Aim 2) To examine the associations between rural cancer patients’ perception of care coordination and specific care delivery outcomes (time from first symptoms to diagnosis, time from diagnosis to treatment initiation). These aims will inform specific care coordination processes that disproportionately impact rural cancer patients and ways to improve rural cancer care delivery. Findings will guide the development of future interventions focused on improving rural cancer care delivery and may contribute to improved quality and value of cancer care, reduce burdens related to care delivery for rural cancer patients, and address rural cancer health disparities. The proposed research advances the Agency for Healthcare Research and Quality (AHRQ)’s focus on research and evaluation of health care delivery in a priority population residing in rural areas. The proposed fellowship is designed to enhance the applicant’s knowledge and skills in health services research under expert mentorship and a mentoring committee, and includes a larger training plan developed to prepare the applicant for the next step in her career toward becoming an independent investigator. Training and research will be conducted at one of the 70 National Cancer Institute-designated cancer centers. Upon completion of the proposed research and training, the applicant will be ideally poised to submit a complete K01 application focused on developing and testing an intervention aimed to improve cancer care coordination in rural areas. Her current and future research aims will advance AHRQ’s mission by focusing on the delivery of health care in a high priority population residing in rural areas.

项目总结/摘要 虽然癌症治疗的进步提高了患者的总体生存率，但农村地区的癌症死亡率 人口仍然不成比例地高于城市人口。癌症死亡率的城乡差异 据认为，这一比率在一定程度上反映了农村地区护理协调欠佳的情况。农村癌症患者 地区面临更大的护理协调挑战，包括获得医疗服务的机会有限或缺乏，旅行 负担、专家短缺以及接受诊断和诊断后干预的延误。延误 诊断和治疗的开始已经显示出对患者存活率的不利影响;这种延迟已经被 与三倍的癌症死亡风险相关。然而，对农村癌症患者的看法知之甚少 具体癌症护理协调过程中的城乡差异，以及 农村癌症护理协调具体的护理提供成果。拟议的研究将解决这些问题 目的1）比较农村和城市癌症患者的认知水平， 护理协调的感知和目的2）检查农村癌症患者的护理协调之间的关联， 护理协调和特定护理交付结果的感知（从首次症状到诊断的时间， 从诊断到治疗开始）。这些目标将为具体的护理协调进程提供信息， 对农村癌症患者造成不成比例的影响，以及改善农村癌症护理提供的方法。发现将 指导未来干预措施的发展，重点是改善农村癌症护理服务，并可能有助于 提高癌症护理的质量和价值，减轻农村癌症患者的护理负担， 并解决农村癌症健康差距。这项拟议中的研究推动了医疗保健机构 研究和质量（AHRQ）的重点是研究和评估重点人群的医疗保健服务 居住在农村地区。拟议的研究金旨在提高申请人的知识和技能， 在专家指导和指导委员会的指导下进行卫生服务研究，并包括更大的培训 计划制定，以准备申请人在她的职业生涯的下一步，成为一个独立的 调查员培训和研究将在70个国家癌症研究所指定的 癌症中心在完成拟议的研究和培训后，申请人将准备好 提交完整的K 01申请，重点是开发和测试旨在改善癌症的干预措施 在农村地区进行协调。她目前和未来的研究目标将推进AHRQ的使命， 为居住在农村地区的高度优先人口提供保健服务。