Patient Administrative Burden in Cancer Care Delivery

癌症护理中的患者行政负担

• 批准号: 10580183
• 负责人: Michael Anne Kyle
• 金额: $ 14.76万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10580183
• 关键词: Adherence; Antineoplastic Agents; Architecture; Caregivers; Caring; Characteristics; Clinical; Communities; Complement; Complex; Comprehensive Cancer Center; Data; Dedications; Development; Diagnosis; Doctor of Philosophy; Education; Emergency department visit; Equity; Failure; Financial cost; Focus Groups; Future; Goals; Guidelines; Health; Health Policy; Health Services Accessibility; Health system; Healthcare Systems; Hospitalization; Inequity; Knowledge; Link; Low income; Malignant Neoplasms; Managed Care; Measurement; Measures; Mentors; Methods; Modality; Oncology; Oral; Outcome; Patients; Persons; Pharmacy facility; Phase; Policies; Policy Maker; Prevalence; Process; Property; Proxy; Psychometrics; Quality of Care; Recommendation; Recurrent Malignant Neoplasm; Reporting; Research; Research Personnel; Respondent; Role; Services; Site; Stress; Supportive care; Survey Methodology; Surveys; Time; Training; Validation; Work; cancer care; cancer recurrence; cancer therapy; care coordination; care delivery; care outcomes; career development; chemotherapy; cost; data repository; design; health disparity; high risk; improved; informal caregiving; innovation; insight; marginalization; marginalized population; medication compliance; novel; outreach; patient engagement; programs; recruit; repository; response; success; theories

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.

项目总结/摘要 美国医疗保健系统在行政复杂性及其相关成本方面领先世界。研究 行政成本主要集中在卫生保健系统的成本上，很少包括病人， 虽然患者经常执行大量的行政工作，这意味着时间，努力，以及导航的压力， 卫生系统获得，支付和协调护理。癌症是一种复杂且通常高敏度的疾病， 健康结果的持续差异，使癌症护理服务成为评估患者的优先事项 行政负担和确定解决办法。这项研究计划利用多种方法， 定义、测量和描述癌症护理提供中患者管理负担对质量的影响 和护理结果，包括口服抗癌药依从性和指南推荐的支持性护理。 这个早期的K99/R 00将建立迈克尔安妮凯尔，博士，注册护士作为一个独立的调查员，重点是 通过降低非财务成本来提高癌症护理的质量和价值。培训目标 先进的调查和心理测量方法和癌症护理提供将支持博士凯尔的成功，她在她的 研究目标和向独立的过渡。一个优秀的导师团队将指导她的培训， 职业发展。K99阶段的重点是确定癌症护理提供中的患者管理负担 并开发一种调查工具来衡量它。它将让患者或患者代理人参加焦点小组 阐明癌症护理管理中涉及的面向患者的非临床任务（目标1a）。定性见解 将告知一种新的测量患者管理的调查工具的开发和验证， 负担及其心理测量特性（目标1b）。R 00阶段，将给予经确认的患者 对NCI大型综合癌症中心（Aim）癌症患者的行政负担调查 2a）。然后，它将把病人调查数据与实践特征数据联系起来，以检查这种关系 组织特征与行政负担之间的关系。(Aim 2b）。最后，它将把调查与 患者水平的利用数据负担，以检查行政负担和癌症护理之间的关系 质量，包括对口服抗癌药的依从性和对指南推荐的支持性治疗的依从性 护理（目标2c）。这些结果将有助于衡量和诊断行政负担 在癌症护理环境中，并提供证据，确定和激励可采取行动的组织或 临床领导者和决策者的政策目标。