Patient Administrative Burden in Cancer Care Delivery

项目摘要/摘要 在管理复杂性及其相关成本方面，美国医疗体系处于世界领先地位。研究与实践 行政成本主要集中在医疗保健系统的成本上，很少包括患者， 虽然患者经常执行大量的管理工作，这意味着导航 卫生系统，以获得、支付和协调护理。癌症是一种复杂的疾病，通常是高度敏锐的 健康结果持续存在差异，使癌症护理服务成为评估患者的优先设置 行政负担和确定解决方案。这项研究计划利用多种方法来 定义、衡量和描述癌症护理服务中患者管理负担对质量的影响 以及护理结果，包括口服抗癌药物的依从性和指南推荐的支持性护理。 这一早期的K99/R00将确立Michael Anne Kyle，PhD，RN作为独立调查员的地位，专注于 通过降低非财务成本提高癌症护理服务的质量和价值。培训目标： 先进的调查和心理测量方法以及癌症护理的提供将支持凯尔博士在HERE 研究目标和向独立的过渡。一支优秀的导师团队将指导她的训练和 职业发展。K99阶段的重点是确定癌症护理服务中患者的行政负担 并开发了一种测量仪器来测量它。它将吸引患者或患者代理人参加焦点小组 阐明管理癌症护理所涉及的面向患者的非临床任务(目标1a)。质的洞察 将为开发和验证一种测量患者管理的新型调查工具提供信息 负担及其心理测量特性(目标1b)。R00阶段，将管理经过验证的患者 大型NCI综合癌症中心癌症患者行政负担调查(AIM) 2a)。然后，它将把患者调查数据与执业特征数据联系起来，以检查两者之间的关系 组织特征与行政负担之间的关系。(目标2b)。最后，它将把调查与 患者层面利用数据负担来检查管理负担与癌症护理之间的关系 质量，包括坚持口服抗癌药物和坚持指南-建议的支持性 关爱(目标2c)。综合起来，这些结果将使行政负担的衡量和诊断成为可能 跨癌症护理环境，并提供证据以确定和激励可操作的组织或 临床领导者和政策制定者的政策目标。

PROJECT SUMMARY/ABSTRACT The US health care system leads the world in administrative complexity and its associated costs. Research on administrative costs has primarily focused on costs to the health care system and rarely includes patients, though patients often perform a lot of administrative work, meaning the time, effort, and stress of navigating the health system to obtain, pay for, and coordinate care. Cancer is a complex and often high-acuity condition with persistent disparities in health outcomes, making cancer care delivery a priority setting for assessing patient administrative burdens and identifying solutions. This program of research harnesses multiple methods to define, measure, and describe the impact of patient administrative burden in cancer care delivery on quality and care outcomes including oral anticancer agent adherence and guideline-recommended supportive care. This early K99/R00 will establish Michael Anne Kyle, PhD, RN as an independent investigator focused on improving the quality and value of cancer care delivery by reducing nonfinancial costs. Training goals in advanced survey and psychometric methods and cancer care delivery will support Dr. Kyle’s success in her research aims and transition to independence. An outstanding team of mentors will guide her training and career development. The K99 phase focuses on defining patient administrative burden in cancer care delivery and developing a survey instrument to measure it. It will engage patients or patient proxies in focus groups elucidating the patient-facing nonclinical tasks involved in managing cancer care (Aim 1a). Qualitative insights will inform the development and validation of a novel survey instrument measuring patient administrative burden and its psychometric properties (Aim 1b). The R00 phase, will administer the validated patient administrative burden survey to patients with cancer across a large NCI Comprehensive Cancer Center (Aim 2a). It will then link patient survey data with data on practice characteristics to examine the relationship between organizational characteristics and administrative burden. (Aim 2b). Finally, it will link the survey with patient-level utilization data burden to examine the relationship between administrative burden and cancer care quality, including adherence to oral anticancer agents and adherence to guideline-recommended supportive care (Aim 2c). Together, these results will enable the measurement and diagnosis of administrative burden across cancer care settings and produce evidence identifying and motivating actionable organizational or policy targets for clinical leaders and policymakers.